Cargando…

Relationship of Extravascular Lung Water and Pulmonary Vascular Permeability to Respiratory Mechanics in Patients with COVID-19-Induced ARDS

During acute respiratory distress syndrome (ARDS), the increase in pulmonary vascular permeability and lung water induced by pulmonary inflammation may be related to altered lung compliance. A better understanding of the interactions between respiratory mechanics variables and lung water or capillar...

Descripción completa

Detalles Bibliográficos
Autores principales: Lardet, Florian, Monnet, Xavier, Teboul, Jean-Louis, Shi, Rui, Lai, Christopher, Fossé, Quentin, Moretto, Francesca, Gobé, Thibaut, Jelinski, Ludwik, Combet, Margot, Pavot, Arthur, Guérin, Laurent, Pham, Tài
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004335/
https://www.ncbi.nlm.nih.gov/pubmed/36902815
http://dx.doi.org/10.3390/jcm12052028
_version_ 1784904807771799552
author Lardet, Florian
Monnet, Xavier
Teboul, Jean-Louis
Shi, Rui
Lai, Christopher
Fossé, Quentin
Moretto, Francesca
Gobé, Thibaut
Jelinski, Ludwik
Combet, Margot
Pavot, Arthur
Guérin, Laurent
Pham, Tài
author_facet Lardet, Florian
Monnet, Xavier
Teboul, Jean-Louis
Shi, Rui
Lai, Christopher
Fossé, Quentin
Moretto, Francesca
Gobé, Thibaut
Jelinski, Ludwik
Combet, Margot
Pavot, Arthur
Guérin, Laurent
Pham, Tài
author_sort Lardet, Florian
collection PubMed
description During acute respiratory distress syndrome (ARDS), the increase in pulmonary vascular permeability and lung water induced by pulmonary inflammation may be related to altered lung compliance. A better understanding of the interactions between respiratory mechanics variables and lung water or capillary permeability would allow a more personalized monitoring and adaptation of therapies for patients with ARDS. Therefore, our main objective was to investigate the relationship between extravascular lung water (EVLW) and/or pulmonary vascular permeability index (PVPI) and respiratory mechanic variables in patients with COVID-19-induced ARDS. This is a retrospective observational study from prospectively collected data in a cohort of 107 critically ill patients with COVID-19-induced ARDS from March 2020 to May 2021. We analyzed relationships between variables using repeated measurements correlations. We found no clinically relevant correlations between EVLW and the respiratory mechanics variables (driving pressure (correlation coefficient [CI 95%]: 0.017 [−0.064; 0.098]), plateau pressure (0.123 [0.043; 0.202]), respiratory system compliance (−0.003 [−0.084; 0.079]) or positive end-expiratory pressure (0.203 [0.126; 0.278])). Similarly, there were no relevant correlations between PVPI and these same respiratory mechanics variables (0.051 [−0.131; 0.035], 0.059 [−0.022; 0.140], 0.072 [−0.090; 0.153] and 0.22 [0.141; 0.293], respectively). In a cohort of patients with COVID-19-induced ARDS, EVLW and PVPI values are independent from respiratory system compliance and driving pressure. Optimal monitoring of these patients should combine both respiratory and TPTD variables.
format Online
Article
Text
id pubmed-10004335
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100043352023-03-11 Relationship of Extravascular Lung Water and Pulmonary Vascular Permeability to Respiratory Mechanics in Patients with COVID-19-Induced ARDS Lardet, Florian Monnet, Xavier Teboul, Jean-Louis Shi, Rui Lai, Christopher Fossé, Quentin Moretto, Francesca Gobé, Thibaut Jelinski, Ludwik Combet, Margot Pavot, Arthur Guérin, Laurent Pham, Tài J Clin Med Article During acute respiratory distress syndrome (ARDS), the increase in pulmonary vascular permeability and lung water induced by pulmonary inflammation may be related to altered lung compliance. A better understanding of the interactions between respiratory mechanics variables and lung water or capillary permeability would allow a more personalized monitoring and adaptation of therapies for patients with ARDS. Therefore, our main objective was to investigate the relationship between extravascular lung water (EVLW) and/or pulmonary vascular permeability index (PVPI) and respiratory mechanic variables in patients with COVID-19-induced ARDS. This is a retrospective observational study from prospectively collected data in a cohort of 107 critically ill patients with COVID-19-induced ARDS from March 2020 to May 2021. We analyzed relationships between variables using repeated measurements correlations. We found no clinically relevant correlations between EVLW and the respiratory mechanics variables (driving pressure (correlation coefficient [CI 95%]: 0.017 [−0.064; 0.098]), plateau pressure (0.123 [0.043; 0.202]), respiratory system compliance (−0.003 [−0.084; 0.079]) or positive end-expiratory pressure (0.203 [0.126; 0.278])). Similarly, there were no relevant correlations between PVPI and these same respiratory mechanics variables (0.051 [−0.131; 0.035], 0.059 [−0.022; 0.140], 0.072 [−0.090; 0.153] and 0.22 [0.141; 0.293], respectively). In a cohort of patients with COVID-19-induced ARDS, EVLW and PVPI values are independent from respiratory system compliance and driving pressure. Optimal monitoring of these patients should combine both respiratory and TPTD variables. MDPI 2023-03-03 /pmc/articles/PMC10004335/ /pubmed/36902815 http://dx.doi.org/10.3390/jcm12052028 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lardet, Florian
Monnet, Xavier
Teboul, Jean-Louis
Shi, Rui
Lai, Christopher
Fossé, Quentin
Moretto, Francesca
Gobé, Thibaut
Jelinski, Ludwik
Combet, Margot
Pavot, Arthur
Guérin, Laurent
Pham, Tài
Relationship of Extravascular Lung Water and Pulmonary Vascular Permeability to Respiratory Mechanics in Patients with COVID-19-Induced ARDS
title Relationship of Extravascular Lung Water and Pulmonary Vascular Permeability to Respiratory Mechanics in Patients with COVID-19-Induced ARDS
title_full Relationship of Extravascular Lung Water and Pulmonary Vascular Permeability to Respiratory Mechanics in Patients with COVID-19-Induced ARDS
title_fullStr Relationship of Extravascular Lung Water and Pulmonary Vascular Permeability to Respiratory Mechanics in Patients with COVID-19-Induced ARDS
title_full_unstemmed Relationship of Extravascular Lung Water and Pulmonary Vascular Permeability to Respiratory Mechanics in Patients with COVID-19-Induced ARDS
title_short Relationship of Extravascular Lung Water and Pulmonary Vascular Permeability to Respiratory Mechanics in Patients with COVID-19-Induced ARDS
title_sort relationship of extravascular lung water and pulmonary vascular permeability to respiratory mechanics in patients with covid-19-induced ards
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004335/
https://www.ncbi.nlm.nih.gov/pubmed/36902815
http://dx.doi.org/10.3390/jcm12052028
work_keys_str_mv AT lardetflorian relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards
AT monnetxavier relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards
AT tebouljeanlouis relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards
AT shirui relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards
AT laichristopher relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards
AT fossequentin relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards
AT morettofrancesca relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards
AT gobethibaut relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards
AT jelinskiludwik relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards
AT combetmargot relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards
AT pavotarthur relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards
AT guerinlaurent relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards
AT phamtai relationshipofextravascularlungwaterandpulmonaryvascularpermeabilitytorespiratorymechanicsinpatientswithcovid19inducedards