Comparison of Respiratory and Hemodynamic Parameters of COVID-19 and Non-COVID-19 ARDS Patients

Abstract

A bstract Background COVID-19 can cause a clinical spectrum from asymptomatic disease to life-threatening respiratory failure and acute respiratory distress syndrome (ARDS). There is an ongoing discussion whether the clinical presentation and ventilatory parameters are the same as typical ARDS or not. There is no clear understanding of how the hemodynamic parameters have been affected in COVID-19 ARDS patients. We aimed to compare hemodynamic and respiratory parameters of moderate and severe COVID-19 and non-COVID-19 ARDS patients. These patients were monitored with an advanced hemodynamic measurement system by the transpulmonary thermodilution method in prone and supine positions. Patients and methods Data of 17 patients diagnosed with COVID-19 and 16 patients diagnosed with other types of diseases with moderate and severe ARDS, mechanically ventilated, placed in a prone position, had advanced hemodynamic measurements with PiCCO, and stayed in the intensive care unit for more than a week were analyzed retrospectively. Patient characteristics and arterial blood gases analysis recorded at admission and respiratory and advanced hemodynamic parameters during the first week were compared in prone and supine positions. Results No difference was observed in the respiratory parameters including respiratory system compliance between COVID-19 and non-COVD-19 patients in prone and supine positions. In comparison of advanced hemodynamic parameters in the first week of intensive care, the extravascular lung water and pulmonary vascular permeability indexes measured in supine position of COVID-19 ARDS patients were found to be significantly higher than non-COVID-19 patients. Duration of prone position was significantly longer in patients diagnosed with COVID-19 ARDS. Conclusions The results of this study suggested that COVID-19 ARDS is a variant of typical ARDS with a different pathophysiology. How to cite this article Asar S, Acicbe Ö, Sabaz MS, Tontu F, Canan E, Cukurova Z, et al . Comparison of Respiratory and Hemodynamic Parameters of COVID-19 and Non-COVID-19 ARDS Patients. Indian J Crit Care Med 2021;25(6):704–708.

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“…This timing is consistent with previous research, both in the context of C-ARDS and non-C-ARDS patients, indicating that the therapeutic benefits of prone positioning tend to become more pronounced around the 5-7 day mark after intubation. [47][48][49] In summary, this study found that the novel saturation and oxygenation indices showed the strongest predictive value for ICU mortality on the third day of treatment. Particularly, OI-ΔP insp , OSI-ΔP insp , and OSI-MP dyn emerged as promising indicators for predicting clinical outcomes.…”

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