Ventilation management in acute respiratory failure related to COVID-19 versus ARDS from another origin – a descriptive narrative review

Figures & data

Figure 1. Search results

Table 1. Characteristics of ‘ARDS of another origin’ studies

Name/study acronym	Ref.	Design	Location	N	Berlin classification	Ventilation characteristics	Reported as
APRONET	43	Pro	Belgium, France and Switzerland	735	25.4%, 54.3% and 20.3% with mild, moderate or severe ARDS	VT, Pplat, PEEP, FiO2, prone positioning, duration	median (IQR), %
Gupta et al.	44	Pro	Peru	514	not reported	VT, Pplat, PEEP, FiO2	mean (SD), proportions ≤ 6 ml/kg PBW
Lanspa et al.	45	Retro	US	1385	24.5%, 48.7% and 26.8% with mild, moderate or severe ARDS	VT, Pplat, PEEP, FiO2	median (IQR)
Leite et al.	46	Retro	US	1142	not reported	VT, Pplat, PEEP	median (IQR), mean (SD)
LOTUS–FRUIT	47	Pro	US	895	not reported	VT	mean (95%CI), proportions ≤ 8 ml/kg PBW
LUNG–SAFE	48	Pro	worldwide study	2377	30.0%, 46.6% and 23.4% with mild, moderate or severe ARDS	VT, Pplat, PEEP, FiO2, prone positioning	mean (95%CI), proportions ≤ 8 ml/kg PBW
Parhar et al.	49	Pro	Canada	633	31.6%, 54.2% and 14.2% with mild, moderate or severe ARDS	VT, Pplat, PEEP	median (IQR), proportions ≤ 8 ml/kg PBW
Schmidt et al.	50	Retro	US	543	not reported	VT, Pplat, PEEP	median (IQR)

Abbreviations: ARDS = acute respiratory distress syndrome; COVID-19 = coronavirus disease 2019; CI = confidence interval; FiO₂ = fraction of inspired oxygen; IQR = interquartile range; PBW = predicted body weight; Pplat = Plateau pressure; PEEP = Positive end-expiratory pressure; Pro = prospective; Retro = retrospective, SD = standard deviation; UK = United Kingdom; US = United States; V_T = Tidal volume

Table 2. Characteristics of ‘acute respiratory failure in COVID-19ʹ studies

Name/study acronym	Ref.	Design	Location	N	Berlin classification	Ventilation characteristics	Reported as
Camporota et al.	51	Retro	UK	213	10.8%, 57.3% and 31.9% with mild, moderate or severe ARDS	VT, PEEP	mean (95%CI)
Chand et al.	52	NA	US	274	4.3%, 35.3% and 52.0% with mild, moderate or severe ARDS	prone positioning	%
COVID–ICU Network	53	Pro	France	2635	24%, 52% and 24% with mild, moderate or severe ARDS	VT, Pplat, PEEP, prone positioning	median (IQR), %
Cummings et al.	54	Pro	US	203	Berlin definition not used	VT, Pplat, PEEP, FiO2, prone positioning	median (IQR), %
Ferrando et al.	55	Pro	Spain	742	17.1%, 44.6% and 38.1% with mild, moderate or severe ARDS	VT, Pplat, PEEP, FiO2, prone positioning	median (IQR), proportions ≤ 6 ml/kg PBW, %
Fusina et al.	56	Retro	Italy	187	not reported	VT, PEEP, FiO2	median (IQR), mean (SD)
Grasselli et al.	57	Retro	Italy	1150	Berlin definition not used	PEEP, FiO2, prone positioning	median (IQR), %
Grasselli et al.	58	Retro	Italy	2929	Berlin definition not used	PEEP, FiO2	median (IQR)
McWilliams et al.	59	Pro	UK	110	Berlin definition not used	prone positioning	%
Primmaz et al.	60	Pro	Switzerland	124	Berlin definition not used	PEEP, FiO2, prone positioning	median (IQR), %
PRoVENT–COVID	61	Retro	Netherlands	553	24.9%, 66.5% and 8.6% with mild, moderate or severe ARDS	VT, PEEP, FiO2, prone positioning, duration	median (IQR), proportion ≤ 6 ml/kg PBW, %
Roedl et al.	62	Retro	Germany	167	4%, 42% and 49% with mild, moderate or severe ARDS	PEEP, prone positioning	median (IQR), %
Schenck et al.	63	NA	US	267	not reported	VT, Pplat, PEEP, prone positioning	median (IQR), %
Thomson et al.	64	Pro	UK	136	Berlin definition not used	PEEP, prone positioning	median (IQR), %

Abbreviations: ARDS = acute respiratory distress syndrome; COVID-19 = coronavirus disease 2019; CI = confidence interval; FiO₂ = fraction of inspired oxygen; IQR = interquartile range; PBW = predicted body weight; Pplat = Plateau pressure; PEEP = Positive end-expiratory pressure; Pro = prospective; Retro = retrospective, SD = standard deviation; UK = United Kingdom; US = United States; V_T = Tidal volume

Figure 2. Summary of ventilation settings in patients with acute respiratory failure related to COVID-19 versus in patients with ARDS from another origin. references are provided between square brackets. green fonts: median or mean VT ≤ 8 ml/kg PBW, PEEP ≤ 10 cm H2O, FiO2 ≤ 60%, and prone ventilation use ≥ 15% – red fonts: median or mean VT > 8 ml/kg PBW, PEEP > 10 cm H2O, FiO2 > 60%, and prone ventilation use < 15% (cutoffs are arbitrarily chosen)