Inspiratory Airway Resistance in Respiratory Failure Due to COVID-19

Bijan Nezami, MD; Hai V. Tran, MD; Kevin Zamora, MD; Peter Lowery, MD; Stephen P. Kantrow, MD; Matt R. Lammi, MD; Bennet P. deBoisblanc, MD

doi:10.1097/CCE.0000000000000669

Critical Care Explorations (Apr 2022)

Inspiratory Airway Resistance in Respiratory Failure Due to COVID-19

Bijan Nezami, MD,
Hai V. Tran, MD,
Kevin Zamora, MD,
Peter Lowery, MD,
Stephen P. Kantrow, MD,
Matt R. Lammi, MD,
Bennet P. deBoisblanc, MD

Affiliations

Bijan Nezami, MD: 1 Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.
Hai V. Tran, MD: 1 Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.
Kevin Zamora, MD: 2 Department of Internal Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.
Peter Lowery, MD: 2 Department of Internal Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.
Stephen P. Kantrow, MD: 1 Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.
Matt R. Lammi, MD: 1 Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.
Bennet P. deBoisblanc, MD: 1 Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.

DOI: https://doi.org/10.1097/CCE.0000000000000669
Journal volume & issue: Vol. 4, no. 4
p. e0669

Abstract

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OBJECTIVES:. To measure inspiratory airflow resistance in patients with acute respiratory distress syndrome (ARDS) due to COVID-19. DESIGN:. Observational cohort of a convenience sample. SETTING:. Three community ICUs. SUBJECTS:. Fifty-five mechanically ventilated patients with COVID-19. INTERVENTIONS:. Measurements of ventilatory mechanics during volume control ventilation. MEASUREMENTS:. Flow-time and pressure-time scalars were used to measure inspiratory airways resistance. RESULTS:. The median inspiratory airflow resistance was 12 cm H2O/L/s (interquartile range, 10–16). Inspiratory resistance was not significantly different among patients with asthma or chronic obstructive pulmonary disease compared with those without a history of obstructive airways disease (median 12.5 vs 12 cm H2O/L/s, respectively; p = 0.66). Survival to 90 days among patients with inspiratory resistance above 12 cm H2O/L/s was 68% compared with 60% for patients below 12 cm H2O/L/s (p = 0.58). Inspiratory resistance did not correlate with C-reactive protein, ferritin, Pao2/Fio2 ratio, or static compliance. CONCLUSIONS:. Inspiratory airflow resistance was normal to slightly elevated among mechanically ventilated patients with ARDS due to COVID-19. Airways resistance was independent of a history of obstructive airways disease, did not correlate with biomarkers of disease severity, and did not predict mortality.

Published in Critical Care Explorations

ISSN: 2639-8028 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Medical emergencies. Critical care. Intensive care. First aid
Website: https://journals.lww.com/ccejournal/pages/default.aspx

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