The Respiratory Mechanics of COVID-19 Acute Respiratory Distress Syndrome-Lessons Learned?

Rebecca L Kummer; John J Marini

doi:10.3390/jcm13071833

The Respiratory Mechanics of COVID-19 Acute Respiratory Distress Syndrome-Lessons Learned?

J Clin Med. 2024 Mar 22;13(7):1833. doi: 10.3390/jcm13071833.

Authors

Rebecca L Kummer¹, John J Marini²

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, University of Minnesota School of Medicine, Minneapolis, MN 55455, USA.
² Department of Pulmonary and Critical Care Medicine, Regions Hospital, St. Paul, MN 55101, USA.

Abstract

Acute respiratory distress syndrome (ARDS) is a well-defined clinical entity characterized by the acute onset of diffuse pulmonary injury and hypoxemia not explained by fluid overload. The COVID-19 pandemic brought about an unprecedented volume of patients with ARDS and challenged our understanding and clinical approach to treatment of this clinical syndrome. Unique to COVID-19 ARDS is the disruption and dysregulation of the pulmonary vascular compartment caused by the SARS-CoV-2 virus, which is a significant cause of hypoxemia in these patients. As a result, gas exchange does not necessarily correlate with respiratory system compliance and mechanics in COVID-19 ARDS as it does with other etiologies. The purpose of this review is to relate the mechanics of COVID-19 ARDS to its underlying pathophysiologic mechanisms and outline the lessons we have learned in the management of this clinic syndrome.

Keywords: ARDS; COVID-19; PEEP; PSILI; VILI.

Publication types

Review

Grants and funding

This research received no external funding.