Patients with COVID-19 who experience acute respiratory distress syndrome (ARDS) commonly require mechanical ventilation. There are numerous studies examining optimal management of and treatment for COVID-19. However, there are few data available on specific ventilation strategies for ARDS.
According to Mark E. Seubert, MD, and Marco Goeijenbier, PhD, support mode during invasive mechanical ventilation is associated with potential benefits that include conserving of diaphragmatic motility, avoiding the negative consequences of the longer use of neuromuscular blockers, and limiting the occurrence of ventilator-induced lung injury. The researchers conducted a retrospective study of confirmed nonhyperdynamic patients with SARS-CoV-2 infection who required mechanical ventilation to examine the association between the occurrence of kidney injury and the decreased ratio of support to controlled ventilation.
The total incidence of AKI in this cohort was low (n=5/41). Sixteen of 41 patients underwent patient-triggered pressure support breathing at least 80% of the time. In that group, there was a lower percentage of AKI (0/16 vs 5/25), determined as a creatinine level above 177 µmol/L in the first 200 hours. There was a negative correlation between time spent on support ventilation and peak creatinine levels (r=–0.35). Disease severity scores were significantly higher in the group predominantly on control ventilation.
“Early patient-triggered ventilation in patients with COVID-19 may be associated with lower rates of acute kidney injury,” the researchers said.
Source: Journal of Clinical Medicine