Altered static respiratory compliance under invasive mechanical ventilation in SARS-CoV-2 infection in the development of respiratory sequelae - 07/12/25
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Abstract |
Background |
Development of respiratory sequelae in COVID-19 associated acute respiratory distress syndrome (ARDS) may occur after a fluctuating period but its physiopathology is not fully understood. Impaired static respiratory compliance (C RS ) in COVID-19 associated ARDS (CARDS), is a risk factor of mortality. However, its predictive role in the development of respiratory sequelae is unknown. The main objective was to determine if initial C RS was associated with the development of long-term respiratory sequelae .
Methods |
In this observational single-center retrospective cohort, patients had a systematic evaluation at three, six and/or twelve months after intensive care unit hospitalization for CARDS. The primary outcome was the presence of COVID-19 respiratory sequelae .
Results |
Out of the 75 patients included, 57 (76.0 %) had respiratory sequelae . Median C RS on the first day of invasive mechanical ventilation was 38.0 [32.0–47.0] ml/cmH 2 O. After adjustment for confounding factors, it was not associated with the risk of developing respiratory sequelae [OR 1.0 (CI 95 % 1.0–1.1, p = 0.5980)]. Nevertheless, between the first and tenth day of invasive ventilation, the C RS of patients with respiratory sequelae worsened (slope: 0.11, p = 0.7570), while that of patients without respiratory sequelae improved (slope: 0.90, p = 0.0623). Multivariate analysis revealed a significant association between respiratory s equelae and age (p = 0.0474), as well as the presence of ventilator-associated pneumonia (p = 0.0125).
Conclusions |
C RS value on the first day of invasive mechanical ventilation was not associated with the risk of developing respiratory sequelae . However, attention should be paid to age, ventilator-associated pneumonia and C RS evolution, to detect patients most at risk of respiratory sequelae .
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | C RS on day one of invasive mechanical ventilation was not associated with respiratory sequelae in patients with CARDS. |
• | In patients with sequelae , C RS worsened over the first ten days of ventilation, while it improved in those without sequelae . |
• | Age and ventilator associated pneumonia (VAP) were significantly associated with long-term respiratory sequelae. |
• | Age, VAP occurrence and C RS evolution during the first ten days may predict respiratory sequelae. |
Keywords : COVID-19, Respiratory insufficiency, Ventilator-induced lung injury, Respiratory distress syndrome
Abbreviations : ARDS, BMI, CARDS, CI, COVID-19, C RS , CT, FiO 2 , FVC, GLI, ICU, LLN, PaO 2 , PEEP, P PLAT , RR, SARS-CoV-2, TLC, TL CO , VAP, VILIs, V T , 6MWT
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Vol 250
Articolo 108541- dicembre 2025 Ritorno al numero
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