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Feasibility of non-invasive respiratory drive and breathing pattern evaluation using CPAP in COVID-19 patients
PURPOSE: Increased respiratory drive and respiratory effort are major features of acute hypoxemic respiratory failure (AHRF) and might help to predict the need for intubation. We aimed to explore the feasibility of a non-invasive respiratory drive evaluation and describe how these parameters may hel...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8929539/ https://www.ncbi.nlm.nih.gov/pubmed/35306443 http://dx.doi.org/10.1016/j.jcrc.2022.154020 |
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author | Dargent, Auguste Hombreux, Alexandra Roccia, Hugo Argaud, Laurent Cour, Martin Guérin, Claude |
author_facet | Dargent, Auguste Hombreux, Alexandra Roccia, Hugo Argaud, Laurent Cour, Martin Guérin, Claude |
author_sort | Dargent, Auguste |
collection | PubMed |
description | PURPOSE: Increased respiratory drive and respiratory effort are major features of acute hypoxemic respiratory failure (AHRF) and might help to predict the need for intubation. We aimed to explore the feasibility of a non-invasive respiratory drive evaluation and describe how these parameters may help to predict the need for intubation. MATERIALS AND METHODS: We conducted a prospective observational study. All consecutive patients with COVID-19-related AHRF requiring high-flow nasal cannula (HFNC) were screened for inclusion. Physiologic data (including: occlusion pressure (P0.1), tidal volume (Vt), inspiratory time (Ti), peak and mean inspiratory flow (Vt/Ti)) were collected during a short continuous positive airway pressure (CPAP) session. Measurements were repeated once, 12–24 h later. RESULTS: Measurements were completed in 31 patients after the screening of 45 patients (70%). P0.1 was high (4.4 [2.7–5.1]), but it was not significantly higher in patients who were intubated. The Vt (p = .006), Vt/Ti (p = .019), minute ventilation (p = .006), and Ti/Ttot (p = .003) were higher among intubated patients compared to non-intubated patients. Intubated patients had a significant increase in their diaphragm thickening fraction, Vt, and Vt/Ti over time. CONCLUSIONS: Non-invasive assessment of respiratory drive was feasible in patients with AHRF and showed an increased P0.1, although it was not predictive of intubation. |
format | Online Article Text |
id | pubmed-8929539 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89295392022-03-18 Feasibility of non-invasive respiratory drive and breathing pattern evaluation using CPAP in COVID-19 patients Dargent, Auguste Hombreux, Alexandra Roccia, Hugo Argaud, Laurent Cour, Martin Guérin, Claude J Crit Care Article PURPOSE: Increased respiratory drive and respiratory effort are major features of acute hypoxemic respiratory failure (AHRF) and might help to predict the need for intubation. We aimed to explore the feasibility of a non-invasive respiratory drive evaluation and describe how these parameters may help to predict the need for intubation. MATERIALS AND METHODS: We conducted a prospective observational study. All consecutive patients with COVID-19-related AHRF requiring high-flow nasal cannula (HFNC) were screened for inclusion. Physiologic data (including: occlusion pressure (P0.1), tidal volume (Vt), inspiratory time (Ti), peak and mean inspiratory flow (Vt/Ti)) were collected during a short continuous positive airway pressure (CPAP) session. Measurements were repeated once, 12–24 h later. RESULTS: Measurements were completed in 31 patients after the screening of 45 patients (70%). P0.1 was high (4.4 [2.7–5.1]), but it was not significantly higher in patients who were intubated. The Vt (p = .006), Vt/Ti (p = .019), minute ventilation (p = .006), and Ti/Ttot (p = .003) were higher among intubated patients compared to non-intubated patients. Intubated patients had a significant increase in their diaphragm thickening fraction, Vt, and Vt/Ti over time. CONCLUSIONS: Non-invasive assessment of respiratory drive was feasible in patients with AHRF and showed an increased P0.1, although it was not predictive of intubation. Elsevier Inc. 2022-06 2022-03-17 /pmc/articles/PMC8929539/ /pubmed/35306443 http://dx.doi.org/10.1016/j.jcrc.2022.154020 Text en © 2022 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Dargent, Auguste Hombreux, Alexandra Roccia, Hugo Argaud, Laurent Cour, Martin Guérin, Claude Feasibility of non-invasive respiratory drive and breathing pattern evaluation using CPAP in COVID-19 patients |
title | Feasibility of non-invasive respiratory drive and breathing pattern evaluation using CPAP in COVID-19 patients |
title_full | Feasibility of non-invasive respiratory drive and breathing pattern evaluation using CPAP in COVID-19 patients |
title_fullStr | Feasibility of non-invasive respiratory drive and breathing pattern evaluation using CPAP in COVID-19 patients |
title_full_unstemmed | Feasibility of non-invasive respiratory drive and breathing pattern evaluation using CPAP in COVID-19 patients |
title_short | Feasibility of non-invasive respiratory drive and breathing pattern evaluation using CPAP in COVID-19 patients |
title_sort | feasibility of non-invasive respiratory drive and breathing pattern evaluation using cpap in covid-19 patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8929539/ https://www.ncbi.nlm.nih.gov/pubmed/35306443 http://dx.doi.org/10.1016/j.jcrc.2022.154020 |
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