Respiratory Mechanics and Gas Exchange Characteristics in Patient With SARS-CoV-2

Respiratory System Mechanics and Gas Exchange Characteristics Applying Different Ventilatory Strategies in Patients With SARS-CoV-2

The combination of different ventilatory strategies and its effects on respiratory mechanics and gas exchange in patients under mechanical ventilation with acute respiratory distress syndrome secondary to coronavirus-19 has been scarcely described.

Investigation in mechanically ventilated patients with with acute respiratory distress syndrome (ARDS) secondary to coronavirus-19 (COVID-19) is emerging due to presumed differences with typical ARDS from other origin. Considering these issues, the effects of ventilatory strategies such as positive end expiratory pressure, end inspiratory pause and fraction of inspired oxygen on respiratory mechanics and gas exchange must be studied in order to characterize the behavior of COVID-19 ARDS during invasive mechanical ventilation and choose the best combination of ventilatory settings.

In this study the investigators will evaluate the changes in respiratory mechanics and gas exchange produced by low and high positive end expiratory pressure, low and high inspired oxygen fraction and the application of end inspiratory pause during volume controlled mechanical ventilation.

Inclusion Criteria:

• Older than 18 years old
• less than 72 hs since ARDS diagnosis
• Moderate to severe ARDS
• central venous catheter and arterial line available
• Need of neuromuscular blocking agents
• Supine position
• Informed consent accepted
• Airway opening pressure lower than 20 cmH2O

Exclusion Criteria:

• RASS target higher than -5
• COPD diagnosis
• Pneumothorax
• Intracraneal Hypertension
• Pregnancy
• Cardiac inssuficiency uncompensated
• Chest wall deformity
• Bronchopleural fistula
• Contraindication to use esophageal manometry