In the present context, it seems necessary to try to describe as precisely as possible the physiological alterations due to COVID-19. From these observations, therapeutic proposals adapted to this new disease may then be developed, particularly in the symptomatic management of the critically ill patient. It therefore seems essential to rigorously study these modifications, as they have been studied in the past for ARDS. The aim of this non-interventional study is to describe precisely the respiratory and hemodynamic changes induced by COVID-19 in mechanically ventilated patients .
Inclusion Criteria:
- hospitalized in intensive care for a SARS-CoV2 infection
- requiring invasive ventilation,
- intubated for less than 72 hours with PaO2/FiO2 ratio < 200 mmHg
Exclusion Criteria:
- Patient mechanically ventilated for 72 hours or more
- Patient with documented respiratory co-infection
- Patient with a contraindication to pulmonary artery catheter insertion: High risk of
bleeding, pre-existing high degree of atrioventricular heart block , Pace Maker
- Patient with spontaneous ventilation
- Patient with severe ARDS with static compliance of the respiratory system < 20
mL/cmH2O
- Patient with severe ARDS with indication of prone positioning at inclusion.
- Patient with a cardiac condition that renders the measurement of pulmonary artery
occlusion pressure uninterpretable as a surrogate for left ventricle end diastolic
pressure (severe mitral insufficiency, severe mitral stricture, severe aortic
insufficiency).
- Patient with intracardiac shunt
- Patient with ECMO
- Minors and pregnant women.
- Person not affiliated to or not benefiting from a social security scheme.
Hopital Roger Salengro, CHU Lille
Lille, France
Thibault Duburcq, MD, Principal Investigator
University Hospital, Lille