COVID-19 pneumonia: ARDS or not?

The lung’s gas volume is high, the recruitability is minimal, and the hypoxemia is likely due to the loss of hypoxic pulmonary vasoconstriction and impaired regulation of pulmonary blood flow. [...]severe hypoxemia is primarily due to ventilation/perfusion (VA/Q) mismatch. [...]some of these hypoxem...

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Published in:Critical care (London, England) Vol. 24; no. 1; pp. 154 - 3
Main Authors: Gattinoni, Luciano, Chiumello, Davide, Rossi, Sandra
Format: Journal Article
Language:English
Published: London BioMed Central 16.04.2020
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
ARDS
Betacoronavirus - isolation & purification
Clinical Laboratory Techniques
Coronavirus Infections - diagnosis
Coronavirus Infections - diagnostic imaging
Coronavirus Infections - therapy
Coronaviruses
COVID-19
COVID-19 Testing
Critical care
Critical Care Medicine
Edema
Editorial
Emergency Medicine
Humans
Hypoxemia
Intensive
Intubation
Mechanical ventilation
Medicine
Medicine & Public Health
Pandemics
Pneumonia
Pneumonia, Viral - diagnostic imaging
Pneumonia, Viral - therapy
Respiratory distress syndrome
Respiratory therapy
SARS-CoV-2
Thrombosis
Tomography, X-Ray Computed
Ventilators
United Kingdom
COVID-19
Mechanical ventilation
ARDS
ISSN:1364-8535, 1466-609X, 1364-8535, 1466-609X, 1366-609X
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Summary:The lung’s gas volume is high, the recruitability is minimal, and the hypoxemia is likely due to the loss of hypoxic pulmonary vasoconstriction and impaired regulation of pulmonary blood flow. [...]severe hypoxemia is primarily due to ventilation/perfusion (VA/Q) mismatch. [...]some of these hypoxemic patients receive CPAP or non-invasive ventilation before ICU admission and present with very high respiratory drives, vigorous inspiratory efforts, and highly negative intrathoracic pressures. [...]in addition to viral pneumonia, those patients likely have self-inflicted ventilator-induced lung injury [4]. Acute Respiratory Distress Syndrome N, Brower RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, Wheeler A. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.
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ISSN:1364-8535
1466-609X
1364-8535
1466-609X
1366-609X
DOI:10.1186/s13054-020-02880-z