Ventilatory load reduction by combined mild hypothermia and ultraprotective mechanical ventilation strategy in severe COVID-19-related acute respiratory distress syndrome: A physiological study

• DOI: 10.4103/tjem.tjem_339_22
• Publication Date: 2024-04-05T14:00:27Z
• Authors: Pablo Cruces; Diego Moreno; Sonia Reveco; Yenny Ramírez; Franco Díaz
• Keywords: Interquartile range

We report the feasibility of a combined approach very low tidal volume (VT) and mild therapeutic hypothermia (MTH) to decrease ventilatory load in severe COVID-19-related acute respiratory distress syndrome (ARDS) cohort. Inclusion criteria was patients ≥18-years-old, ARDS, driving pressure ∆P >15 cmH 2 O despite low-VT strategy, extracorporeal therapies not available. MTH induced with surface cooling device aiming at 34°C. maintained for 72 h, followed by rewarming 1°C per day. Data were shown median (interquartile range, 25%–75%). Mixed effects analysis Dunnett’s test used comparisons. Seven reported. Ventilatory decreased during first 24 minute ventilation (VE) from 173 (170–192) 152 (137–170) mL/kg/min ( P = 0.007), mechanical power (MP) 37 (31–40) 29 (26–34) J/min 0.03). At end period, VT, , plateau remained consistently close 3.9 mL/kg predicted body weight, 12 26 O, respectively. A strategy ultraprotective (MV) VE MP ARDS. The decreasing may allow maintaining MV within safety thresholds.