دورية أكاديمية
أعرض في EDS

Correlation between normally aerated lung and respiratory system compliance at clinical high positive end-expiratory pressure in patients with COVID-19.

التفاصيل البيبلوغرافية
العنوان: Correlation between normally aerated lung and respiratory system compliance at clinical high positive end-expiratory pressure in patients with COVID-19.
المؤلفون: Ogura K; Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, Sapporo, Japan., Nakayama R; Department of Emergency Medicine, Sapporo Medical University School of Medicine, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, 060-8556, Japan. ryuichin.smu99@gmail.com., Bunya N; Department of Emergency Medicine, Sapporo Medical University School of Medicine, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, 060-8556, Japan., Katayama S; Division of Intensive Care, Department of Anesthesiology and Intensive Care Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, 329-0498, Japan., Yama N; Department of Diagnostic Radiology, Sapporo Medical University School of Medicine, Sapporo, Japan., Goto Y; Department of Intensive Care Medicine, School of Medicine, Sapporo Medical University, Sapporo, Hokkaido, Japan., Sawamoto K; Department of Emergency Medicine, Sapporo Medical University School of Medicine, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, 060-8556, Japan., Uemura S; Department of Emergency Medicine, Sapporo Medical University School of Medicine, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, 060-8556, Japan., Narimatsu E; Department of Emergency Medicine, Sapporo Medical University School of Medicine, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, 060-8556, Japan.
المصدر: Scientific reports [Sci Rep] 2024 Jun 24; Vol. 14 (1), pp. 14477. Date of Electronic Publication: 2024 Jun 24.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : Nature Publishing Group, copyright 2011-
مواضيع طبية MeSH: COVID-19*/physiopathology , COVID-19*/therapy , Positive-Pressure Respiration*/methods , Lung*/physiopathology , Lung*/diagnostic imaging , Tomography, X-Ray Computed*, Humans ; Male ; Female ; Aged ; Middle Aged ; SARS-CoV-2 ; Respiratory Mechanics/physiology ; Respiratory Distress Syndrome/therapy ; Respiratory Distress Syndrome/physiopathology ; Respiratory Distress Syndrome/diagnostic imaging ; Lung Compliance ; Aged, 80 and over
مستخلص: Normally aerated lung tissue on computed tomography (CT) is correlated with static respiratory system compliance (C rs ) at zero end-expiratory pressure. In clinical practice, however, patients with acute respiratory failure are often managed using elevated PEEP levels. No study has validated the relationship between lung volume and tissue and C rs at the applied positive end-expiratory pressure (PEEP). Therefore, this study aimed to demonstrate the relationship between lung volume and tissue on CT and C rs during the application of PEEP for the clinical management of patients with acute respiratory distress syndrome due to COVID-19. Additionally, as a secondary outcome, the study aimed to evaluate the relationship between CT characteristics and C rs , considering recruitability using the recruitment-to-inflation ratio (R/I ratio). We analyzed the CT and respiratory mechanics data of 30 patients with COVID-19 who were mechanically ventilated. The CT images were acquired during mechanical ventilation at PEEP level of 15 cmH 2 O and were quantitatively analyzed using Synapse Vincent system version 6.4 (Fujifilm Corporation, Tokyo, Japan). Recruitability was stratified into two groups, high and low recruitability, based on the median R/I ratio of our study population. Thirty patients were included in the analysis with the median R/I ratio of 0.71. A significant correlation was observed between C rs at the applied PEEP (median 15 [interquartile range (IQR) 12.2, 15.8]) and the normally aerated lung volume (r = 0.70 [95% CI 0.46-0.85], P < 0.001) and tissue (r = 0.70 [95% CI 0.46-0.85], P < 0.001). Multivariable linear regression revealed that recruitability (Coefficient = - 390.9 [95% CI - 725.0 to - 56.8], P = 0.024) and C rs (Coefficient = 48.9 [95% CI 32.6-65.2], P < 0.001) were significantly associated with normally aerated lung volume (R-squared: 0.58). In this study, C rs at the applied PEEP was significantly correlated with normally aerated lung volume and tissue on CT. Moreover, recruitability indicated by the R/I ratio and C rs were significantly associated with the normally aerated lung volume. This research underscores the significance of C rs at the applied PEEP as a bedside-measurable parameter and sheds new light on the link between recruitability and normally aerated lung.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Computed tomography; Coronavirus disease 2019; Mechanical ventilation; Recruitability; Respiratory distress syndrome; Respiratory system compliance
تواريخ الأحداث: Date Created: 20240624 Date Completed: 20240624 Latest Revision: 20240627
رمز التحديث: 20240627
مُعرف محوري في PubMed: PMC11196724
DOI: 10.1038/s41598-024-64622-3
PMID: 38914620
قاعدة البيانات: MEDLINE
الوصف
تدمد:2045-2322
DOI:10.1038/s41598-024-64622-3