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. 2023 Feb 26;12(5):1859.
doi: 10.3390/jcm12051859.

Early Patient-Triggered Pressure Support Breathing in Mechanically Ventilated Patients with COVID-19 May Be Associated with Lower Rates of Acute Kidney Injury

Mark E Seubert  1 , Marco Goeijenbier  2   3
Affiliations

Early Patient-Triggered Pressure Support Breathing in Mechanically Ventilated Patients with COVID-19 May Be Associated with Lower Rates of Acute Kidney Injury

Mark E Seubert et al. J Clin Med. .

Abstract

Background: Acute respiratory distress syndrome (ARDS) in COVID-19 patients often necessitates mechanical ventilation. Although much has been written regarding intensive care admission and treatment for COVID-19, evidence on specific ventilation strategies for ARDS is limited. Support mode during invasive mechanical ventilation offers potential benefits such as conserving diaphragmatic motility, sidestepping the negative consequences of the longer usage of neuromuscular blockers, and limiting the occurrence of ventilator-induced lung injury (VILI).

Methods: In this retrospective cohort study of mechanically ventilated and confirmed non-hyperdynamic SARS-CoV-2 patients, we studied the relation between the occurrence of kidney injury and the decreased ratio of support to controlled ventilation.

Results: Total AKI incidence in this cohort was low (5/41). In total, 16 of 41 patients underwent patient-triggered pressure support breathing at least 80% of the time. In this group we observed a lower percentage of AKI (0/16 vs. 5/25), determined as a creatinine level above 177 µmol/L in the first 200 h. There was a negative correlation between time spent on support ventilation and peak creatinine levels (r = -0.35 (-0.6-0.1)). The group predominantly on control ventilation showed significantly higher disease severity scores.

Conclusions: Early patient-triggered ventilation in patients with COVID-19 may be associated with lower rates of acute kidney injury.

Keywords: COVID-19; acute kidney injury (AKI); acute respiratory distress syndrome (ARDS); mechanical ventilation; ventilator-induced kidney injury (VIKI).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
First panel shows the peak creatinine levels in µmol/L during the ICU stay in patients with a ratio (PS/PC + PS) above 80% and below 80%. A trend is seen but is not statistically significant (p = 0.072). In the second panel a significant negative correlation (r = −0.35) is seen between peak creatinine levels and the predominance of controlled ventilation.
See this image and copyright information in PMC

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