अमूर्त

Death rate in SARS-CoV-2 under mechanical ventilation: What influences?

Luciano Franck C

Introduction: The Acute Respiratory Distress Syndrome caused by the Coronavirus 2019 (SARSCoV-2) may associate the Acute Respiratory Distress Syndrome (ARDS) and the Ventilation Induced Lung Injury (VILI). However, there are still doubts about the potential damage generators and its influence onpatient outcome. Objective: To analyze the mechanical ventilation and the factors that influence the mortality in SARS-CoV-2. Assess the outcomes based on age, on parameters of the mechanical ventilator, on Mechanical Power and on its fragments through univariate and multivariate analysis of age, Peep, Driving Pressure, elastance and Mechanical Power. Method: Observational, longitudinal, analytical and quantitative study of age and of the parameters of the mechanical ventilator, alongside the calculous of the Mechanical Power and its components of patients with SARS-CoV-2. Results: We identified significant impact on the outcome in the univariate analysis of age (p<0.001), respiratory rate (p=0.047), elastance (p<0.001), complacency (p<0.001), driving pressure (p<0.001), inspiratory pressure variation (p<0.001), peak pressure (p=0.009), plateau pressure (p<0.013), Peep (p<0.001), dynamic elastic power (p<0.001) and static elastic power (p=0.005). In the multivariate analysis the increase in age (p<0.001), in elastance (p=0.0029) and in Mechanical Power (p=0.023), and the reduction in Peep (p=0.044) showed significant impact on the death risk. Conclusion: The increase in age and in Mechanical Power - caused by the rise in its dynamic elastic power component, and reduction of its static elastic power factor - influenced the death rate of patients with SARS-CoV-2 under mechanical ventilation. The variance of the elastic power components may reflect adequately the propulsion power required to overcome the rise in elastance and the lack of responsiveness to Peep adjustments.