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TUESDAY, May 12, 2020 (HealthDay News) — Many critically ill patients with COVID-19 respiratory failure managed with mechanical ventilation and established acute respiratory distress syndrome (ARDS) protocols survive, according to a letter to the editor published online April 29 in the American Journal of Respiratory and Critical Care Medicine<\/i>.<\/p>\n
David R. Ziehr, M.D., from Massachusetts General Hospital in Boston, and colleagues present the respiratory pathophysiology of 66 adult patients with COVID-19 respiratory failure treated with invasive mechanical ventilation.<\/p>\n
The researchers found that 85 percent of the patients met Berlin criteria for ARDS and most had mild-to-moderate ARDS. The median positive end-expiratory pressure (PEEP) was 10 cm H2<\/sub>O on intubation. The ratio of arterial oxygen partial pressure to fractional inspired oxygen was 150 in the 31 patients who underwent prone ventilation and compliance was 33 mL\/cm H2<\/sub>O immediately before prone positioning and increased to 232 and 36 mL\/cm H2<\/sub>O, respectively, after prone positioning. Patients underwent prone ventilation for a median of two sessions (median, 18 hours\/session) over 72 hours. Concurrent neuromuscular blockade was received by 12 patients. Median PEEP was 13 and 14 cm H2<\/sub>O while supine and prone, respectively. Overall, 41 of the patients were successfully extubated, with a median of 16.0 days of mechanical ventilation. Tracheostomy was performed in 14 patients. A majority of the patients (50 patients; 75.8 percent) were discharged from the intensive care unit. There were 11 deaths (16.7 percent).<\/p>\n “We recommend that clinicians provide evidence-based ARDS treatments to patients with respiratory failure due to COVID-19 and await standardized clinical trials before contemplating novel therapies,” a coauthor said in a statement.<\/p>\n Several authors disclosed financial ties to the pharmaceutical industry.<\/p>\n Abstract\/Full Text (subscription or payment may be required)<\/a><\/p>\n <\/i><\/p>\n