SARS-CoV-2-induced Acute Respiratory Distress Syndrome: Pulmonary Mechanics and Gas Exchange Abnormalities.

The aim of the article was to present the characteristics of gas exchange, pulmonary mechanics, and ventilatory management of 50 patients with laboratory-confirmed SARS-CoV-2 infection, who developed ARDS and underwent invasive MV (IMV) By March 25th, 2020, 50 patients with laboratory-confirmed SARS-CoV-2 infection and ARDS had been admitted to our hospital Table 1 shows the demographic and clinical characteristics of these patients The median (interquartile range [IQR]) age was 66 (57-74) years Thirty-six patients (72%) were men Upon ARDS diagnosis, 44% of patients were initially classified as having moderate ARDS, whereas 24% were classified as having mild ARDS and 32% were classified as having severe ARDS ICU and hospital lengths of stay were prolonged, and tracheostomy was performed in 30 (60%) patients Hospital mortality was 34% SARS-CoV-2-induced ARDS produced an impairment in gas exchange and pulmonary mechanics comparable with those of prior cohorts with non-SARS-CoV-2 ARDS As in other studies, VR was high, and the most frequent presentation was moderate ARDS On average, Crs in the cohort with SARS-CoV-2-induced ARDS was also found to be comparable, but with remarkable heterogeneity Other studies have reported similar, higher, or lower Crs in SARS-CoV-2-induced ARDS As Crs decreases alongside the collapse of alveolar units due to lung edema, several factors may provide explanations for such reported differences, including treatments, intubation strategies, and the stage of the disease In our cohort with early SARS-CoV-2-induced ARDS, the time from ICU admission to intubation was only 24 hours, despite the use of high-flow nasal cannula or NIV in some cases Although driving pressure and end-inspiratory plateau pressure were within the protective range, mechanical power was found to be slightly high and might have promoted lung injury In patients undergoing prone positioning, PaO2/FiO2 improvement was followed by an increase in Crs, suggesting recruitment and aeration of previously collapsed alveoli In this study, mortality was similar to that reported in other studies of critically ill patients with SARS-CoV-2 pneumonia