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Comment
. 2020 Aug 15;202(4):626-628.
doi: 10.1164/rccm.202004-1041LE.

Mechanics of Breathing and Gas Exchange in Mechanically Ventilated Patients with COVID-19-associated Respiratory Failure

Philippe Haouzi  1 , Areeb Zamir  1 , Eduardo Villarreal-Fernandez  1 , Dana Stauffer  1 , Lauren Ventola  1 , Danish Ahmad  1 , Ami Dewaters  1 , Muhammad Khalid  1 , Margaret Wojnar  1
Affiliations
Comment

Mechanics of Breathing and Gas Exchange in Mechanically Ventilated Patients with COVID-19-associated Respiratory Failure

Philippe Haouzi et al. Am J Respir Crit Care Med. .
No abstract available

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Figures

Figure 1.
Figure 1.
(A) Values of compliance (Crs) collected in mechanically ventilated patients with coronavirus disease (COVID-19) compared with data reported in acute respiratory distress syndrome (the references of the selected studies are given in the figure). Although data were not obtained at the same time of the disease, alterations of the elastic properties of the respiratory system can be significant in all these patients and are not dramatically different between patients with COVID-19 and acute respiratory distress syndrome. (B) Relationship between positive end-expiratory pressure (PEEP) and Crs, showing that when low levels of PEEP were used, low Crs was always present (see text for comments and discussion). (C) Crs versus PaO2–alveolar PO2 (PaO2) gradient. Extreme deterioration of the PaO2–PaO2 gradient was observed in many patients; however, although the patients with the lowest Crs have the greatest gradient, the correlation remains weak in this limited population. (D) Relationship between the Crs/PEEP ratio and the PaO2–PaO2 gradient; the ratio was used as an indicator of the effects of PEEP applied at any given Crs. The patients with the lowest ratio had the highest gradient, with a significant correlation between the two variables. (E) Iso–dead space (iso-Vd) curves showing the relationship between Vt and Vd/Vt ratio. By minimally increasing Vt, the change in Vd/Vt ratio and thus in alveolar gas composition improves out of proportion of the changes in serial Vd (see text for further comments). ARDS = acute respiratory distress syndrome.
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