Early effects of ventilatory rescue therapies on systemic and cerebral oxygenation in mechanically ventilated COVID-19 patients with acute respiratory distress syndrome: a prospective observational study

Bibliographic Details
Title: Early effects of ventilatory rescue therapies on systemic and cerebral oxygenation in mechanically ventilated COVID-19 patients with acute respiratory distress syndrome: a prospective observational study
Authors: Chiara Robba, Lorenzo Ball, Denise Battaglini, Danilo Cardim, Emanuela Moncalvo, Iole Brunetti, Matteo Bassetti, Daniele R. Giacobbe, Antonio Vena, Nicolò Patroniti, Patricia R. M. Rocco, Basil F. Matta, Paolo Pelosi, collaborators
Source: Critical Care, Vol 25, Iss 1, Pp 1-13 (2021)
Publisher Information: BMC, 2021.
Publication Year: 2021
Collection: LCC:Medical emergencies. Critical care. Intensive care. First aid
Subject Terms: Coronavirus, Cerebral oxygenation, Rescue therapies, Prone position, Recruitment maneuvers, Carbon dioxide removal, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
More Details: Abstract Background In COVID-19 patients with acute respiratory distress syndrome (ARDS), the effectiveness of ventilatory rescue strategies remains uncertain, with controversial efficacy on systemic oxygenation and no data available regarding cerebral oxygenation and hemodynamics. Methods This is a prospective observational study conducted at San Martino Policlinico Hospital, Genoa, Italy. We included adult COVID-19 patients who underwent at least one of the following rescue therapies: recruitment maneuvers (RMs), prone positioning (PP), inhaled nitric oxide (iNO), and extracorporeal carbon dioxide (CO2) removal (ECCO2R). Arterial blood gas values (oxygen saturation [SpO2], partial pressure of oxygen [PaO2] and of carbon dioxide [PaCO2]) and cerebral oxygenation (rSO2) were analyzed before (T0) and after (T1) the use of any of the aforementioned rescue therapies. The primary aim was to assess the early effects of different ventilatory rescue therapies on systemic and cerebral oxygenation. The secondary aim was to evaluate the correlation between systemic and cerebral oxygenation in COVID-19 patients. Results Forty-five rescue therapies were performed in 22 patients. The median [interquartile range] age of the population was 62 [57–69] years, and 18/22 [82%] were male. After RMs, no significant changes were observed in systemic PaO2 and PaCO2 values, but cerebral oxygenation decreased significantly (52 [51–54]% vs. 49 [47–50]%, p
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1364-8535
Relation: https://doaj.org/toc/1364-8535
DOI: 10.1186/s13054-021-03537-1
Access URL: https://doaj.org/article/eaa43f38b26544f89b9f3fa05edf7d41
Accession Number: edsdoj.43f38b26544f89b9f3fa05edf7d41
Database: Directory of Open Access Journals
More Details
ISSN:13648535
DOI:10.1186/s13054-021-03537-1
Published in:Critical Care
Language:English