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The following is a summary of “Differences of respiratory mechanics in mechanical ventilation of acute respiratory distress syndrome between patients with COVID-19 and Influenza A,” published in the March 2024 issue of Pulmonology by Chung et al.

The management of acute respiratory distress syndrome (ARDS) in COVID-19 patients has raised questions about potential differences in respiratory mechanical characteristics compared to other viral-induced ARDS cases like influenza A. To address this, the study aimed to investigate whether there are distinct respiratory mechanical features between COVID-19-induced ARDS and influenza A-induced ARDS, providing insights into tailored mechanical ventilation strategies for COVID-19 patients.

Researchers conducted a retrospective cohort study involving ICU patients diagnosed with ARDS secondary to COVID-19 or influenza A between January 2015 and July 2021. Respiratory mechanics parameters were collected at specific intervals on days one, three, and seven post-intubation.

Among the 87 participants, with a median age of 71.0 years and 63.2% male, COVID-19-induced ARDS exhibited a lower ratio of partial pressure of oxygen in arterial blood to the fractional inspiratory oxygen concentration compared to influenza A-induced ARDS during the initial stages of mechanical ventilation (p = 0.009, day 1). Additionally, positive end-expiratory pressure was consistently higher in the COVID-19 group throughout the observation period (p < 0.001, day 1). Although peak inspiratory pressure and dynamic compliance initially differed between COVID-19 and influenza A groups, convergence was observed after day 3. Notably, dynamic driving pressure showed divergent trends between the two groups during mechanical ventilation.

The study highlights discernible differences in respiratory mechanics between COVID-19-induced ARDS and influenza A-induced ARDS. These findings underscore the importance of tailoring mechanical ventilation strategies based on the specific characteristics of ARDS associated with different viral etiologies, informing future treatment approaches for COVID-19-induced ARDS.

Source: respiratory-research.biomedcentral.com/articles/10.1186/s12931-024-02730-4