![]() ![]() Pan C, Chen L, Lu C, Zhang W, Xia JA, Sklar MC, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med. Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, et al. We suggest using prone position for an extended period of time (e.g., 3–5 days) and apply lower PEEP levels as much as possible. In conclusion, we show that higher PEEP levels decrease lung compliance and in most cases increase dead space ventilation, indicating that high PEEP levels probably cause hyperinflation in patients with COVID-19. Redistribution of blood flow seems to be an important mechanism. Īll patients responded extremely well to prone positioning, although the exact mechanism is unclear. When lung compliance increases in response to higher PEEP levels (patient 1), recruitment is likely and PEEP should be set accordingly. ![]() These results are in accordance with recent findings in COVID-19 patients. The decrease in lung compliance and increase in dead space ventilation in response to higher PEEP levels indicate that COVID-19 lesions were not recruited and that higher PEEP levels cause hyperinflation of the more compliant parts of the lung. In almost all patients, lung compliance decreased and dead space ventilation increased with increasing PEEP levels. We demonstrate that mechanically ventilated patients with COVID-19 have a relatively high lung compliance, high dead space ventilation, and gas exchange impairment. ![]()
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