Skip to main content
 

Main menu

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Archives
    • Most-Read Papers of 2022
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Reviewer Guidelines: Original Research
    • Reviewer Guidelines: Reviews
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • 2023 Call for Abstracts
    • 2022 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Videos
    • Video Abstracts
    • Author Interviews
    • Highlighted Articles
    • The Journal

User menu

  • Subscribe
  • My alerts
  • Log in

Search

  • Advanced search
American Association for Respiratory Care
  • Subscribe
  • My alerts
  • Log in
American Association for Respiratory Care

Advanced Search

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Archives
    • Most-Read Papers of 2022
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Reviewer Guidelines: Original Research
    • Reviewer Guidelines: Reviews
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • 2023 Call for Abstracts
    • 2022 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Videos
    • Video Abstracts
    • Author Interviews
    • Highlighted Articles
    • The Journal
  • Twitter
  • Facebook
  • YouTube
Research ArticleOriginal Research

Respiratory Mechanics and Association With Inflammation in
COVID-19-Related ARDS

Alok Bhatt, Himanshu Deshwal, Kelsey Luoma, Madelin Fenianos, Kerry Hena, Nishay Chitkara, Hua Zhong and Vikramjit Mukherjee
Respiratory Care November 2021, 66 (11) 1673-1683; DOI: https://doi.org/10.4187/respcare.09156
Alok Bhatt
Division of Pulmonary, Critical Care, and Sleep Medicine, New York University Grossman School of Medicine, New York, New York.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Himanshu Deshwal
Division of Pulmonary, Critical Care, and Sleep Medicine, New York University Grossman School of Medicine, New York, New York.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: [email protected]
Kelsey Luoma
Division of Pulmonary, Critical Care, and Sleep, University of California, San Diego, San Diego, California.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Madelin Fenianos
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Morningside and Mount Sinai West, New York, New York.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kerry Hena
Division of Pulmonary, Critical Care, and Sleep Medicine, New York University Grossman School of Medicine, New York, New York.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nishay Chitkara
Division of Pulmonary, Critical Care, and Sleep Medicine, New York University Grossman School of Medicine, New York, New York.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Hua Zhong
Department of Biostatistics, Epidemiology, and Research Design, New York University Grossman School of Medicine, New York, New York.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Vikramjit Mukherjee
Division of Pulmonary, Critical Care, and Sleep Medicine, New York University Grossman School of Medicine, New York, New York.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

BACKGROUND: The novel coronavirus-associated ARDS (COVID-19 ARDS) often requires invasive mechanical ventilation. A spectrum of atypical ARDS with different phenotypes (high vs low static compliance) has been hypothesized in COVID-19.

METHODS: We conducted a retrospective analysis to identify respiratory mechanics in COVID-19 ARDS. Berlin definition was used to categorize severity of ARDS. Correlational analysis using t test, chi-square test, ANOVA test, and Pearson correlation was used to identify relationship between subject variables and respiratory mechanics. The primary outcome was duration of mechanical ventilation. Secondary outcomes were correlation between fluid status, C- reactive protein, PEEP, and D-dimer with respiratory and ventilatory parameters.

RESULTS: Median age in our cohort was 60.5 y with predominantly male subjects. Up to 53% subjects were classified as severe ARDS (median Embedded Image = 86) with predominantly low static compliance (median Cst- 25.5 mL/cm H2O). The overall mortality in our cohort was 61%. The total duration of mechanical ventilation was 35 d in survivors and 14 d in nonsurvivors. High PEEP (r = 0.45, P < .001) and D-dimer > 2,000 ng/dL (P = .009) correlated with significant increase in physiologic dead space without significant correlation with Embedded Image. Higher net fluid balance was inversely related to static compliance (r = −0.24, P = .045), and elevation in C- reactive protein was inversely related to Embedded Image (r = −0.32, P = .02).

CONCLUSIONS: In our cohort of mechanically ventilated COVID-19 ARDS subjects, high PEEP and D-dimer were associated with increase in physiologic dead space without significant effect on oxygenation, raising the question of potential microvascular dysfunction.

  • COVID-19
  • SARS-CoV-2
  • COVID-ARDS
  • ARDS
  • respiratory mechanics
  • positive end-expiratory pressure
  • PEEP

Footnotes

  • Correspondence: Himanshu Deshwal MD, Division of Pulmonary, Critical Care, and Sleep and Medicine, New York University Grossman School of Medicine, New York, New York. E-mail: himanshu.deshwal{at}gmail.com
  • The authors have no conflicts of interest to disclose.

  • Copyright © 2021 by Daedalus Enterprises
View Full Text

Pay Per Article - You may access this article (from the computer you are currently using) for 1 day for US$30.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

Log in using your username and password

Forgot your user name or password?
PreviousNext
Back to top

In this issue

Respiratory Care: 66 (11)
Respiratory Care
Vol. 66, Issue 11
1 Nov 2021
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author

 

Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Association for Respiratory Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Respiratory Mechanics and Association With Inflammation in COVID-19-Related ARDS
(Your Name) has sent you a message from American Association for Respiratory Care
(Your Name) thought you would like to see the American Association for Respiratory Care web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Respiratory Mechanics and Association With Inflammation in
COVID-19-Related ARDS
Alok Bhatt, Himanshu Deshwal, Kelsey Luoma, Madelin Fenianos, Kerry Hena, Nishay Chitkara, Hua Zhong, Vikramjit Mukherjee
Respiratory Care Nov 2021, 66 (11) 1673-1683; DOI: 10.4187/respcare.09156

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Respiratory Mechanics and Association With Inflammation in
COVID-19-Related ARDS
Alok Bhatt, Himanshu Deshwal, Kelsey Luoma, Madelin Fenianos, Kerry Hena, Nishay Chitkara, Hua Zhong, Vikramjit Mukherjee
Respiratory Care Nov 2021, 66 (11) 1673-1683; DOI: 10.4187/respcare.09156
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Introduction
    • Methods
    • Data Collection and Definitions
    • Results
    • Discussion
    • Conclusions
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • References
  • PDF

Related Articles

Cited By...

Keywords

  • COVID-19
  • SARS-CoV-2
  • COVID-ARDS
  • ARDS
  • respiratory mechanics
  • positive end-expiratory pressure
  • PEEP

Info For

  • Subscribers
  • Institutions
  • Advertisers

About Us

  • About the Journal
  • Editorial Board

AARC

  • Membership
  • Meetings
  • Clinical Practice Guidelines

More

  • Contact Us
  • RSS
American Association for Respiratory Care

Print ISSN: 0020-1324        Online ISSN: 1943-3654

© Daedalus Enterprises, Inc.

Powered by HighWire