Compliance of the aerated lung at PEEP 5 cmH 2 O (C BABY LUNG ). Left panel: C BABY LUNG as a function of ARDS severity. Right panel. Relationship between hyperinflation-to-recruitment ratio and C BABY LUNG as a function of ECMO status. Circles are individual datapoints. Black line is the regression line on the whole population. a, p < 0.05 vs severe ARDS under ECMO. ARDS, acute respiratory distress syndrome, ECMO, extracorporeal membrane oxygenation, MODERATE, moderate ARDS, PEEP, positive end-expiratory pressure, SEVERE, severe ARDS without ECMO, SEVERE ECMO, severe ARDS under ECMO

Compliance of the aerated lung at PEEP 5 cmH 2 O (C BABY LUNG ). Left panel: C BABY LUNG as a function of ARDS severity. Right panel. Relationship between hyperinflation-to-recruitment ratio and C BABY LUNG as a function of ECMO status. Circles are individual datapoints. Black line is the regression line on the whole population. a, p < 0.05 vs severe ARDS under ECMO. ARDS, acute respiratory distress syndrome, ECMO, extracorporeal membrane oxygenation, MODERATE, moderate ARDS, PEEP, positive end-expiratory pressure, SEVERE, severe ARDS without ECMO, SEVERE ECMO, severe ARDS under ECMO

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Background PEEP selection in severe COVID-19 patients under extracorporeal membrane oxygenation (ECMO) is challenging as no study has assessed the alveolar recruitability in this setting. The aim of the study was to compare lung recruitability and the impact of PEEP on lung aeration in moderate and severe ARDS patients with or without ECMO, using c...

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Context 1
... dioxide partial pressure in arterial blood, PaO 2 oxygen partial pressure in arterial blood, PBW predicted body weight, PEEP positive end-expiratory pressure, PEEP tot,rs total PEEP of the respiratory system, P peak peak airway pressure, P plat,rs plateau pressure of the respiratory system, RR respiratory rate, VT tidal volume moderate ARDS (Fig. 7, left panel). C BABY LUNG was linearly related to the logarithm of the hyperinflation-torecruitment ratio (Fig. 7, right panel). Multivariate analysis identified BMI, ECMO, and EELV at PEEP 5 cmH 2 O as independent variables significantly associated with C BABY LUNG (Additional file 7), while C BABY LUNG was not independently ...
Context 2
... weight, PEEP positive end-expiratory pressure, PEEP tot,rs total PEEP of the respiratory system, P peak peak airway pressure, P plat,rs plateau pressure of the respiratory system, RR respiratory rate, VT tidal volume moderate ARDS (Fig. 7, left panel). C BABY LUNG was linearly related to the logarithm of the hyperinflation-torecruitment ratio (Fig. 7, right panel). Multivariate analysis identified BMI, ECMO, and EELV at PEEP 5 cmH 2 O as independent variables significantly associated with C BABY LUNG (Additional file 7), while C BABY LUNG was not independently associated with lung recruitability (Additional file 5 and ...
Context 3
... most of the patients included in large ECMO cohort studies on COVID-19 ARDS were ventilated with substantially lower PEEP levels [28,29]. Our results suggests that the lower compliance of the aerated lung at PEEP 5 cmH 2 O during ECMO (a consequence of lower EELV) may prevent occurrence of PEEP-induced hyperinflation (Figs. 2 and 7). Hyperinflation may have nonetheless been undetected in ECMO patients as it may occur at a level below the resolution of CT, or since the decrease in CT density Fig. 4 Distribution of patients according to recruitability between PEEP 5 and 15 cmH 2 O or tidal hyperinflation. ...

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