Pulmonary pathophysiology development of COVID-19 assessed by serial Electrical Impedance Tomography in the MaastrICCht cohort

Serge J H Heines; Bas C T van Bussel; Melanie J Acampo-de Jong; Frank C Bennis; Rob J J van Gassel; Rald V M Groven; Nanon F L Heijnen; Ben J M Hermans; René Hounjet; Johan van Koll; Mark M G Mulder; Marcel C G van de Poll; Frank van Rosmalen; Ruud Segers; Sander Steyns; Ulrich Strauch; Jeanette Tas; Iwan C C van der Horst; Sander M J van Kuijk; Dennis C J J Bergmans

doi:10.1038/s41598-022-18843-z

Pulmonary pathophysiology development of COVID-19 assessed by serial Electrical Impedance Tomography in the MaastrICCht cohort

Serge J H Heines^*, Bas C T van Bussel, Melanie J Acampo-de Jong, Frank C Bennis, Rob J J van Gassel, Rald V M Groven, Nanon F L Heijnen, Ben J M Hermans, René Hounjet, Johan van Koll, Mark M G Mulder, Marcel C G van de Poll, Frank van Rosmalen, Ruud Segers, Sander Steyns, Ulrich Strauch, Jeanette Tas, Iwan C C van der Horst, Sander M J van Kuijk, Dennis C J J Bergmans

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Patients with SARS-CoV-2 infection present with different lung compliance and progression of disease differs. Measures of lung mechanics in SARS-CoV-2 patients may unravel different pathophysiologic mechanisms during mechanical ventilation. The objective of this prospective observational study is to describe whether Electrical Impedance Tomography (EIT) guided positive end-expiratory pressure (PEEP) levels unravel changes in EIT-derived parameters over time and whether the changes differ between survivors and non-survivors. Serial EIT-measurements of alveolar overdistension, collapse, and compliance change in ventilated SARS-CoV-2 patients were analysed. In 80 out of 94 patients, we took 283 EIT measurements (93 from day 1-3 after intubation, 66 from day 4-6, and 124 from day 7 and beyond). Fifty-one patients (64%) survived the ICU. At admission mean PaO2/FiO2-ratio was 184.3 (SD 61.4) vs. 151.3 (SD 54.4) mmHg, (p = 0.017) and PEEP was 11.8 (SD 2.8) cmH2O vs. 11.3 (SD 3.4) cmH2O, (p = 0.475), for ICU survivors and non-survivors. At day 1-3, compliance was ~ 55 mL/cmH2O vs. ~ 45 mL/cmH2O in survivors vs. non-survivors. The intersection of overdistension and collapse curves appeared similar at a PEEP of ~ 12-13 cmH2O. At day 4-6 compliance changed to ~ 50 mL/cmH2O vs. ~ 38 mL/cmH2O. At day 7 and beyond, compliance was ~ 38 mL/cmH2O with the intersection at a PEEP of ~ 9 cmH2O vs. ~ 25 mL/cmH2O with overdistension intersecting at collapse curves at a PEEP of ~ 7 cmH2O. Surviving SARS-CoV-2 patients show more favourable EIT-derived parameters and a higher compliance compared to non-survivors over time. This knowledge is valuable for discovering the different groups.

Original language	English
Article number	14517
Number of pages	10
Journal	Scientific Reports
Volume	12
Issue number	1
DOIs	https://doi.org/10.1038/s41598-022-18843-z
Publication status	Published - 25 Aug 2022

Keywords

COVID-19
Electric Impedance
Humans
Positive-Pressure Respiration/methods
SARS-CoV-2
Tomography/methods
Tomography, X-Ray Computed/methods

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Heines, S. J. H., van Bussel, B. C. T., Jong, M. J. A., Bennis, F. C., van Gassel, R. J. J., Groven, R. V. M., Heijnen, N. F. L., Hermans, B. J. M., Hounjet, R., van Koll, J., Mulder, M. M. G., van de Poll, M. C. G., van Rosmalen, F., Segers, R., Steyns, S., Strauch, U., Tas, J., van der Horst, I. C. C., van Kuijk, S. M. J., & Bergmans, D. C. J. J. (2022). Pulmonary pathophysiology development of COVID-19 assessed by serial Electrical Impedance Tomography in the MaastrICCht cohort. Scientific Reports, 12(1), Article 14517. https://doi.org/10.1038/s41598-022-18843-z

@article{8b877bd7c9f947869d472f538838ec0d,

title = "Pulmonary pathophysiology development of COVID-19 assessed by serial Electrical Impedance Tomography in the MaastrICCht cohort",

abstract = "Patients with SARS-CoV-2 infection present with different lung compliance and progression of disease differs. Measures of lung mechanics in SARS-CoV-2 patients may unravel different pathophysiologic mechanisms during mechanical ventilation. The objective of this prospective observational study is to describe whether Electrical Impedance Tomography (EIT) guided positive end-expiratory pressure (PEEP) levels unravel changes in EIT-derived parameters over time and whether the changes differ between survivors and non-survivors. Serial EIT-measurements of alveolar overdistension, collapse, and compliance change in ventilated SARS-CoV-2 patients were analysed. In 80 out of 94 patients, we took 283 EIT measurements (93 from day 1-3 after intubation, 66 from day 4-6, and 124 from day 7 and beyond). Fifty-one patients (64%) survived the ICU. At admission mean PaO2/FiO2-ratio was 184.3 (SD 61.4) vs. 151.3 (SD 54.4) mmHg, (p = 0.017) and PEEP was 11.8 (SD 2.8) cmH2O vs. 11.3 (SD 3.4) cmH2O, (p = 0.475), for ICU survivors and non-survivors. At day 1-3, compliance was ~ 55 mL/cmH2O vs. ~ 45 mL/cmH2O in survivors vs. non-survivors. The intersection of overdistension and collapse curves appeared similar at a PEEP of ~ 12-13 cmH2O. At day 4-6 compliance changed to ~ 50 mL/cmH2O vs. ~ 38 mL/cmH2O. At day 7 and beyond, compliance was ~ 38 mL/cmH2O with the intersection at a PEEP of ~ 9 cmH2O vs. ~ 25 mL/cmH2O with overdistension intersecting at collapse curves at a PEEP of ~ 7 cmH2O. Surviving SARS-CoV-2 patients show more favourable EIT-derived parameters and a higher compliance compared to non-survivors over time. This knowledge is valuable for discovering the different groups.",

keywords = "COVID-19, Electric Impedance, Humans, Positive-Pressure Respiration/methods, SARS-CoV-2, Tomography/methods, Tomography, X-Ray Computed/methods",

author = "Heines, {Serge J H} and {van Bussel}, {Bas C T} and Jong, {Melanie J Acampo-de} and Bennis, {Frank C} and {van Gassel}, {Rob J J} and Groven, {Rald V M} and Heijnen, {Nanon F L} and Hermans, {Ben J M} and Ren{\'e} Hounjet and {van Koll}, Johan and Mulder, {Mark M G} and {van de Poll}, {Marcel C G} and {van Rosmalen}, Frank and Ruud Segers and Sander Steyns and Ulrich Strauch and Jeanette Tas and {van der Horst}, {Iwan C C} and {van Kuijk}, {Sander M J} and Bergmans, {Dennis C J J}",

note = "{\textcopyright} 2022. The Author(s).",

year = "2022",

month = aug,

day = "25",

doi = "10.1038/s41598-022-18843-z",

language = "English",

volume = "12",

journal = "Scientific Reports",

issn = "2045-2322",

publisher = "Nature Publishing Group",

number = "1",

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Heines, SJH, van Bussel, BCT, Jong, MJA, Bennis, FC, van Gassel, RJJ, Groven, RVM, Heijnen, NFL, Hermans, BJM, Hounjet, R, van Koll, J , Mulder, MMG , van de Poll, MCG , van Rosmalen, F , Segers, R, Steyns, S, Strauch, U, Tas, J, van der Horst, ICC , van Kuijk, SMJ & Bergmans, DCJJ 2022, 'Pulmonary pathophysiology development of COVID-19 assessed by serial Electrical Impedance Tomography in the MaastrICCht cohort', Scientific Reports, vol. 12, no. 1, 14517. https://doi.org/10.1038/s41598-022-18843-z

TY - JOUR

T1 - Pulmonary pathophysiology development of COVID-19 assessed by serial Electrical Impedance Tomography in the MaastrICCht cohort

AU - Heines, Serge J H

AU - van Bussel, Bas C T

AU - Jong, Melanie J Acampo-de

AU - Bennis, Frank C

AU - van Gassel, Rob J J

AU - Groven, Rald V M

AU - Heijnen, Nanon F L

AU - Hermans, Ben J M

AU - Hounjet, René

AU - van Koll, Johan

AU - Mulder, Mark M G

AU - van de Poll, Marcel C G

AU - van Rosmalen, Frank

AU - Segers, Ruud

AU - Steyns, Sander

AU - Strauch, Ulrich

AU - Tas, Jeanette

AU - van der Horst, Iwan C C

AU - van Kuijk, Sander M J

AU - Bergmans, Dennis C J J

PY - 2022/8/25

Y1 - 2022/8/25

N2 - Patients with SARS-CoV-2 infection present with different lung compliance and progression of disease differs. Measures of lung mechanics in SARS-CoV-2 patients may unravel different pathophysiologic mechanisms during mechanical ventilation. The objective of this prospective observational study is to describe whether Electrical Impedance Tomography (EIT) guided positive end-expiratory pressure (PEEP) levels unravel changes in EIT-derived parameters over time and whether the changes differ between survivors and non-survivors. Serial EIT-measurements of alveolar overdistension, collapse, and compliance change in ventilated SARS-CoV-2 patients were analysed. In 80 out of 94 patients, we took 283 EIT measurements (93 from day 1-3 after intubation, 66 from day 4-6, and 124 from day 7 and beyond). Fifty-one patients (64%) survived the ICU. At admission mean PaO2/FiO2-ratio was 184.3 (SD 61.4) vs. 151.3 (SD 54.4) mmHg, (p = 0.017) and PEEP was 11.8 (SD 2.8) cmH2O vs. 11.3 (SD 3.4) cmH2O, (p = 0.475), for ICU survivors and non-survivors. At day 1-3, compliance was ~ 55 mL/cmH2O vs. ~ 45 mL/cmH2O in survivors vs. non-survivors. The intersection of overdistension and collapse curves appeared similar at a PEEP of ~ 12-13 cmH2O. At day 4-6 compliance changed to ~ 50 mL/cmH2O vs. ~ 38 mL/cmH2O. At day 7 and beyond, compliance was ~ 38 mL/cmH2O with the intersection at a PEEP of ~ 9 cmH2O vs. ~ 25 mL/cmH2O with overdistension intersecting at collapse curves at a PEEP of ~ 7 cmH2O. Surviving SARS-CoV-2 patients show more favourable EIT-derived parameters and a higher compliance compared to non-survivors over time. This knowledge is valuable for discovering the different groups.

AB - Patients with SARS-CoV-2 infection present with different lung compliance and progression of disease differs. Measures of lung mechanics in SARS-CoV-2 patients may unravel different pathophysiologic mechanisms during mechanical ventilation. The objective of this prospective observational study is to describe whether Electrical Impedance Tomography (EIT) guided positive end-expiratory pressure (PEEP) levels unravel changes in EIT-derived parameters over time and whether the changes differ between survivors and non-survivors. Serial EIT-measurements of alveolar overdistension, collapse, and compliance change in ventilated SARS-CoV-2 patients were analysed. In 80 out of 94 patients, we took 283 EIT measurements (93 from day 1-3 after intubation, 66 from day 4-6, and 124 from day 7 and beyond). Fifty-one patients (64%) survived the ICU. At admission mean PaO2/FiO2-ratio was 184.3 (SD 61.4) vs. 151.3 (SD 54.4) mmHg, (p = 0.017) and PEEP was 11.8 (SD 2.8) cmH2O vs. 11.3 (SD 3.4) cmH2O, (p = 0.475), for ICU survivors and non-survivors. At day 1-3, compliance was ~ 55 mL/cmH2O vs. ~ 45 mL/cmH2O in survivors vs. non-survivors. The intersection of overdistension and collapse curves appeared similar at a PEEP of ~ 12-13 cmH2O. At day 4-6 compliance changed to ~ 50 mL/cmH2O vs. ~ 38 mL/cmH2O. At day 7 and beyond, compliance was ~ 38 mL/cmH2O with the intersection at a PEEP of ~ 9 cmH2O vs. ~ 25 mL/cmH2O with overdistension intersecting at collapse curves at a PEEP of ~ 7 cmH2O. Surviving SARS-CoV-2 patients show more favourable EIT-derived parameters and a higher compliance compared to non-survivors over time. This knowledge is valuable for discovering the different groups.

KW - COVID-19

KW - Electric Impedance

KW - Humans

KW - Positive-Pressure Respiration/methods

KW - SARS-CoV-2

KW - Tomography/methods

KW - Tomography, X-Ray Computed/methods

U2 - 10.1038/s41598-022-18843-z

DO - 10.1038/s41598-022-18843-z

M3 - Article

C2 - 36008523

SN - 2045-2322

VL - 12

JO - Scientific Reports

JF - Scientific Reports

IS - 1

M1 - 14517

ER -

Pulmonary pathophysiology development of COVID-19 assessed by serial Electrical Impedance Tomography in the MaastrICCht cohort

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Keywords

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