Role of total lung stress on the progression of early COVID-19 pneumonia: collinearity and potential confounders

Neetz, Benjamin; Meis, Jan; Herth, Felix J.F.; Trudzinski, Franziska

doi:10.1007/s00134-021-06557-1

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…Secondly the abdominal muscles are recruited under exercise [ 20 ]. The concomitant rise in abdominal pressure is transmitted into the pleural space, which elevates the end-expiratory P oes and thereby the ΔP oes [ 21 ]. Since the associated increase in ΔP oes in this case is not attributable to the diaphragm, this could weaken the correlation between DTF and ΔP oes .…”

Section: Discussionmentioning

confidence: 99%

Correlation of diaphragm thickening fraction and oesophageal pressure swing in non-invasive ventilation of healthy subjects

Lindner,

Hoermann,

Teichert

et al. 2024

BMC Pulm Med

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Introduction The diaphragm thickening fraction (DTF) may be a valuable tool for estimating respiratory effort in non-invasive ventilation. The primary aim of this physiological study is the investigation of the correlation of DTF with oesophageal pressure swings (ΔPoes). A secondary aim is to assess the discriminatory capacity of the index tests for different exercise loads. Methods Healthy volunteers underwent spontaneous breathing and non-invasive ventilation with a sequence of different respirator settings. The first sequence was carried out at rest. The same sequence was repeated twice, with additional ergometry of 25 and 50 Watts, respectively. DTF and ΔPoes were measured during each ventilation configuration. Results 23 individuals agreed to participate. DTF was moderately correlated with ΔPoes (repeated measures correlation ρ = 0.410, p < 0.001). Both ΔPoes and DTF increased consistently with exercise loading in every ventilation configuration, however ΔPoes showed greater discriminatory capacity. Conclusion DTF was moderately correlated with ΔPoes and could discriminate reasonably between exercise loads in a small cohort of non-invasively ventilated healthy subjects. While it may not accurately reflect the absolute respiratory effort, DTF might help titrating individual non-invasive respiratory support. Further investigations are needed to test this hypothesis. Trial Registration This study was not prospectively registered.

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Section: Discussionmentioning

confidence: 99%

Correlation of diaphragm thickening fraction and oesophageal pressure swing in non-invasive ventilation of healthy subjects

Lindner,

Hoermann,

Teichert

et al. 2024

BMC Pulm Med

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“…The conclusions of the article were critically commented by Neetz B et al (170) Furthermore,in most of the autoptic studies published so far, a multy-fold increase of lung weight has been regularly found in hospitalized COVID-19-patients who died of the disease. It remains therefore difficult to allocate the groups of patients with different oxygenations (PaO2/FiO2 from226 to 83 in moderate-severe to 65 in severe ARDS) and significantly different FiO2 but no different pH.…”

Section: Fig4 Ct-scan Oft He Cest Of Patients With Ards Of Different ...mentioning

confidence: 91%

SARS-CoV-2-Infection (COVID-19): Clinical Course and Cause(s) of Death

Ramadori¹

2022

Preprint

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Two years after first patients approached the emergency rooms of hospitals in Wuhan becouse of respiratory distress,thousend of SARS-CoV-2 infected persons continue to die every day worldwide.SARS-CoV-2-infected patients undergo a process of dehydration and malnutrition before they develop respiratory problems and approach the emergency room of a hospital.This is,in many cases, the consequence of high fever which causes massive loss of fluids. In addition loss of appetite, is responsible for the deficit of protein intake.Most of the virus-infected patients admitted to the emergency room are therefore hypovolemic and hypoproteinemic and suffer of respiratory distress accompanied by ground grass opacities at CT-scan of the lungs.Critically ill patients are treated following the guidelines for treatment of septic shock but with &bdquo;conservative“ fluid replacement and administration of diuretics to assure sufficient hourly urine production. The combination of conservative fluid administration with reduced protein content in the enterally administered diet, together with administration of diuretics, has severe hemodynamic consequenses in mostly aged,dehydrated,critically ill patients. Many of them will develop acute kidney injury in the next 24 hours.In most of the cases, patients continue to loose weight by loosing skeletal muscle mass. Ischemic damage in the lung capillaries is responsible for the acute respiratory distreass syndrome (ARDS) and for the hallmark of autoptic findings,diffuse alveolar damage (DAD) characterized by hyaline membrane formation,fluid invasion of the alveoli recruitment of some inflammatory cells and progressive arrest of blood flow in the pulmonary vessels.The consequence is progressive congestion , increase of lung weight and progressive hypoxia (progressive severity of ARDS).Sequestration of blood in the lungs worsen hypovolemia and ischemia in different organs.This is most probably responsible for recruitment of inflammatory cells and for persistance of elevated serum levels of positive acute-phase markers and of hypoalbuminemia. Autoptic studies have been performed mostly in patients who died in the ICU after SARS-CoV-2-infection because of progessive ARDS.In those patients, tubulus epithelium necrosis in the kidney is a frequent finding as it has been the case in the first SARS-CoV-1 pandemic.In the death certification charts, many times weeks after first symptoms have started ,cardiac arrest is the cause of death after respitatory insufficiency.Replacement therapy with sufficient amount of fluid and albumin should be part of the early individualized life-saving supportive measures avoiding mechanical ventilation.

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Development of a nomogram prediction model for severity of acute pancreatitis based on echocardiography parameters and systemic immunoinflammatory index

Shen,

Zhu

2023

WCJD

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Role of total lung stress on the progression of early COVID-19 pneumonia: collinearity and potential confounders

Cited by 3 publications

References 7 publications

Correlation of diaphragm thickening fraction and oesophageal pressure swing in non-invasive ventilation of healthy subjects

Correlation of diaphragm thickening fraction and oesophageal pressure swing in non-invasive ventilation of healthy subjects

SARS-CoV-2-Infection (COVID-19): Clinical Course and Cause(s) of Death

Development of a nomogram prediction model for severity of acute pancreatitis based on echocardiography parameters and systemic immunoinflammatory index

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