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Research ArticleOriginal Research

Corrected Minute Ventilation Is Associated With Mortality in ARDS Caused by COVID-19

Federica Fusina, Filippo Albani, Michele Bertelli, Erika Cavallo, Serena Crisci, Rosalba Caserta, Maia Nguyen, Michele Grazioli, Valeria Schivalocchi, Antonio Rosano and Giuseppe Natalini
Respiratory Care April 2021, 66 (4) 619-625; DOI: https://doi.org/10.4187/respcare.08314
Federica Fusina
Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy.
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  • For correspondence: [email protected]
Filippo Albani
Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy.
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Michele Bertelli
Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy.
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Erika Cavallo
Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy.
Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Rome, Italy.
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Serena Crisci
Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy.
Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Rome, Italy.
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Rosalba Caserta
Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy.
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Maia Nguyen
Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy.
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Michele Grazioli
Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy.
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Valeria Schivalocchi
Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy.
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Antonio Rosano
Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy.
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Giuseppe Natalini
Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy.
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Abstract

BACKGROUND: The ratio of dead space to tidal volume (VD/VT) is associated with mortality in patients with ARDS. Corrected minute ventilation (Embedded Image) is a simple surrogate of dead space, but, despite its increasing use, its association with mortality has not been proven. The aim of our study was to assess the association between Embedded Image and hospital mortality. We also compared the strength of this association with that of estimated VD/VT and ventilatory ratio.

METHODS: We performed a retrospective study with prospectively collected data. We evaluated 187 consecutive mechanically ventilated subjects with ARDS caused by novel coronavirus disease (COVID-19). The association between Embedded Image and hospital mortality was assessed in multivariable logistic models. The same was done for estimated VD/VT and ventilatory ratio.

RESULTS: Mean ± SD Embedded Image was 11.8 ± 3.3 L/min in survivors and 14.5 ± 3.9 L/min in nonsurvivors (P < .001) and was independently associated with mortality (adjusted odds ratio 1.15, P = .01). The strength of association of Embedded Image with mortality was similar to that of VD/VT and ventilatory ratio.

CONCLUSIONS: Embedded Image was independently associated with hospital mortality in subjects with ARDS caused by COVID-19. Embedded Image could be used at the patient’s bedside for outcome prediction and severity stratification, due to the simplicity of its calculation. These findings need to be confirmed in subjects with ARDS without viral pneumonia and when lung-protective mechanical ventilation is not rigorously applied.

  • respiration
  • artificial
  • pneumonia
  • viral

Footnotes

  • Correspondence: Federica Fusina MD, Department of Anesthesia, Intensive Care and Pain Medicine, via Bissolati 57, Brescia, 25124, Italy. E-mail: f.fusina{at}gmail.com
  • Supplementary material related to this paper is available at http://www.rcjournal.com.

  • The authors have disclosed no conflicts of interest.

  • Copyright © 2021 by Daedalus Enterprises
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Respiratory Care: 66 (4)
Respiratory Care
Vol. 66, Issue 4
1 Apr 2021
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Corrected Minute Ventilation Is Associated With Mortality in ARDS Caused by COVID-19
Federica Fusina, Filippo Albani, Michele Bertelli, Erika Cavallo, Serena Crisci, Rosalba Caserta, Maia Nguyen, Michele Grazioli, Valeria Schivalocchi, Antonio Rosano, Giuseppe Natalini
Respiratory Care Apr 2021, 66 (4) 619-625; DOI: 10.4187/respcare.08314

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Corrected Minute Ventilation Is Associated With Mortality in ARDS Caused by COVID-19
Federica Fusina, Filippo Albani, Michele Bertelli, Erika Cavallo, Serena Crisci, Rosalba Caserta, Maia Nguyen, Michele Grazioli, Valeria Schivalocchi, Antonio Rosano, Giuseppe Natalini
Respiratory Care Apr 2021, 66 (4) 619-625; DOI: 10.4187/respcare.08314
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Keywords

  • respiration
  • artificial
  • pneumonia
  • viral

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