Evaluation of limiting PEEP effectiveness in preventing barotrauma in critically ill COVID-19 patients: A retrospective study - 24/06/25
, Yoshito Izutani, MD, Junta Noake, MD, Shun Ninomiya, MD, Mami Kastumura, MD, Maiko Nakashio, MD, Junichi Maruyama, MD, Yoshihiko Nakamura, MD, Hiroyasu Ishikura, MD
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Abstract |
Background |
Severe acute respiratory syndrome coronavirus 2 can cause acute respiratory distress syndrome, requiring prolonged invasive mechanical ventilation. However, patients with coronavirus disease 2019 (COVID-19) undergoing invasive mechanical ventilation experience barotrauma. We assessed whether limiting the maximum positive end-expiratory pressure (PEEP) may prevent barotrauma more effectively than using PEEP/fraction of inspired oxygen (FiO 2 ) in patients with COVID-19 undergoing invasive mechanical ventilation.
Materials and methods |
We retrospectively included patients who met the diagnostic criteria at our center; they were divided into an ordinary PEEP group (PEEP/higher FiO 2 table) and a limited PEEP group (maximum PEEP of < 10 cmH 2 O) during intensive care unit admission. We evaluated the maximum ventilator variables for mechanical ventilation and limited PEEP to inhibit barotrauma as the primary outcome.
Results |
Patients in the ordinary PEEP group ( n = 34) were significantly older and had higher body mass indexes than those in the limited PEEP group ( n = 27). The maximum PEEP and maximum peak inspiratory pressure were significantly higher in the ordinary PEEP group than in the limited PEEP group. The ordinary PEEP group had a significantly higher incidence of barotrauma than the limited PEEP group.
Conclusions |
Limiting the maximum PEEP to < 10 cmH 2 O may prevent barotrauma in patients with COVID-19 undergoing invasive mechanical ventilation.
Le texte complet de cet article est disponible en PDF.Keywords : Severe acute respiratory syndrome coronavirus 2, Acute respiratory distress syndrome, Mechanical ventilation, Coronavirus disease 2019, Barotrauma, Positive end-expiratory pressure
Plan
Vol 93
P. 73-79 - juillet 2025 Retour au numéro
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