Introduction
Materials and methods
Study design and population
Study protocol
Outcomes
Statistical analysis
Results
All (n = 12) | EIT first (n = 6) | Tables first (n = 6) | |
---|---|---|---|
Age, median [IQR], years | 61 [48, 68] | 62 [50, 72] | 59.5 [46, 67] |
Female sex, n(%) | 3 (25) | 1 (16) | 2 (33) |
White race, n(%) | 11 (91) | 6 (100) | 5 (83) |
BMI, median [IQR], kg/m2 | 32 [25, 36] | 32 [26, 36] | 32 [24, 36] |
CCI, median [IQR] | 2 (1, 5) | 2 (1, 5) | 2.5 (1, 5) |
Tobacco Use, n(%) | 9 (75) | 4 (66) | 5 (83) |
SAPS II at ICU admission, median [IQR] | 38 [33, 46] | 38 [33, 45] | 40 [33, 48] |
SOFA at ICU admission, median [IQR] | 8 (6, 9) | 7 (6, 9) | 8.5 (7, 10) |
Etiology of ARDS, n(%) | |||
COVID-19 | 7 (58.3) | 4 (66.7) | 3 (50.0) |
Bacterial pneumonia | 4 (33.3) | 2 (33.3) | 2 (33.3) |
Extrapulmonary | 1 (8.3) | 0 (0) | 1 (16.7) |
Pre-intubation NIV and/or HFNC, n(%) | 11 (91.7) | 6 (100) | 5 (83.3) |
PaO2/FiO2 Ratio, median [IQR], mmHg | 130 [112, 140] | 117 [111, 143] | 136 [125, 138] |
MV duration before inclusion, median [IQR], days | 0.6 [0.2, 2] | 0.5 [0.2, 2] | 1 [0.2, 1] |
Vasopressor at baseline, n(%) | 9 (75) | 5 (83.3) | 4 (66.7) |
Sedation at baseline (RASS), median [IQR] | − 4 [− 3, − 4.5] | − 4 [− 3, − 5] | − 3.5 [− 3, − 4] |
Baseline Ventilator Settings*, median [IQR] | |||
Tidal Volume, ml/kg/PBW | 6.0 [5.9, 6.3] | 6.1 [5.7, 6.3] | 6.0 [5.8, 6.3] |
Respiratory rate, breaths/min | 26 [20, 30] | 26 [21, 30] | 26 [20, 31] |
PEEP, cmH2O | 15 (14, 16) | 14 (14, 16) | 16 (14, 16) |
Cstat, ml/cmH2O | 36 [29, 40] | 34 [28, 39] | 36 [32, 42] |
Ppeak, cmH2O | 27 [25, 31] | 29 [27, 35] | 25 [25, 27] |
Pplat, cmH2O | 26 [25, 28] | 27 [26, 28] | 26 [25, 27] |
Driving Pressure, cmH2O | 11 (10, 12) | 12 (12, 14) | 10 (10, 11) |
Mechanical Power†, J/min | 20 [19, 28] | 24 [20, 35] | 19 [18, 22] |
4ΔPxRR Index§, J/min | 70 [64, 83] | 76 [68, 84] | 70 [60, 73] |
Non-Survivors, n(%) | 6 (50) | 3 (50) | 3 (50) |
Change with EIT* | Change with tables** | 95% CI of mean difference | p value | ||
---|---|---|---|---|---|
Mechanical Power1, J/min | − 2.50 ± 3.70 | 1.87 ± 1.61 | − 4.36 | (− 6.77, − 1.95) | 0.002 |
4ΔP + RR Index, J/min | − 6.80 ± 9.36 | 4.62 ± 6.25 | − 11.42 | (− 19.01, − 3.82) | 0.007 |
Elastic–static power2, J/min | − 1.37 ± 2.11 | 0.19 ± 2.28 | − 1.56 | (− 3.71, 0.58) | 0.138 |
Elastic–dynamic power3, J/min | − 1.13 ± 1.66 | 0.48 ± 0.88 | − 1.61 | (− 2.99, − 0.22) | 0.027 |
Resistive power4, J/min | 0.01 ± 3.30 | 1.15 ± 2.48 | − 1.14 | (− 4.59, 2.30) | 0.48 |
Driving Pressure, cmH2O | − 1.58 ± 2.32 | 1.34 ± 1.31 | − 2.92 | (− 4.59, − 1.24) | 0.003 |
PEEP (set), cmH2O | − 1.17 ± 1.80 | 0.83 ± 1.80 | − 2 | (− 3.95, − 0.05) | 0.046 |
Ppeak, cmH2O | − 2.75 ± 3.55 | 3.5 ± 2.78 | − 6.25 | (− 9.79, − 2.71) | 0.003 |
Pplat, cmH2O | − 2.48 ± 3.22 | 2.06 ± 1.88 | − 4.53 | (− 7.45, − 1.62) | 0.006 |
RR, breaths/min | − 0.5 ± 2.35 | − 0.75 ± 2.73 | 0.25 | (− 2.71, 3.21) | 0.856 |
Cstat, ml/cmH2O | 3.24 ± 9.85 | − 4.6 ± 5.26 | 7.93 | (2.54, 13.32) | 0.008 |
PaO2/FiO2 ratio | 25.14 ± 27.11 | − 0.89 ± 60.05 | 26.03 | (− 16.01, 68.06) | 0.2 |