Assessment of Respiratory Mechanics in Patients With Covid- 19 Acute Respiratory Distress Syndrome (ARDS): Are There Mortality Impacts?

Background: The 2019 coronavirus (COVID-19) can generate acute respiratory distress syndrome (ARDS), requiring advanced management within the Intensive Care Unit (ICU) using invasive mechanical ventilation (IMV). However, managing this phenomenon has seen learning and improvements through direct experience. This study aimed to describe the assessment of IMV variables for ARDS patients following COVID-19 hospitalization in the ICU, and their relation with mortality. Methods: Observational and retrospective study. The sample was divided into two, the surviving group (SG) and the non-surviving group (NSG). Clinical data were extracted from the electronic clinical file and the respiratory therapist record sheet. The following information was obtained: Patient medical history: gender, age, co-morbidities, arterial gases, days on IMV, and IMV parameters. Cox proportional regression models for 2–68 days of mortality were estimated to analyze adjusted hazard ratios (HR) by the presence of multimorbidity and ventilation reduction. Results: Out of a total of 101 patients, the total mortality was 32%. There was a significant rise in respiratory rate (RR) (29.12 ± 4.24–26.78 ± 3.59, p = 0.006), Driving pressure (DP) (11.33 ± 2.39–9.67 ± 1.84, p = 0.002), Ventilatory rate (VR) (2.26 ± 0.66–1.89 ± 0.45, p = 0.001) and the partial pressure of carbon dioxide in arterial blood (PCO 2 )(45.91 ± 8.59–41.90 ± 6.4, p = 0.001) and a significant decrease in Static compliance (Cest) (35.49 ± 8.64–41.45 ± 9.62, p = 0.003) and relation between Arterial oxygen pressure/Inspirated oxygen fraction (PaO 2 /FiO 2 ) (201.5 ± 53.98–227.8 ± 52.11, p = 0.008) after 72 hours of IMV, within the NSG compared to the SG. Apart from these points, multi-morbidity (HR = 3.208, p = 0.010) and DP (HR = 1.228, p = 0.030) and VR variables (HR = 2.267, p = 0.027) had more death probabilities. Conclusion: The results of this study indicate that there was a significant increase in FR, DP, VR, and CO 2 and a significant drop in Cest and PaO 2 /FiO 2 among the NSG compared with the SG. Apart from this, the DP and VR variables, multi-morbidity and being male. have more possibility of death.