Respiratory and Hemodynamic Changes Induced in Mechanically Ventilated Patients for COVID-19

Study Overview
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Brief Summary
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In the present context, it seems necessary to try to describe as precisely as possible the physiological alterations due to COVID-19. From these observations, therapeutic proposals adapted to this new disease may then be developed, particularly in the symptomatic management of the critically ill patient. It therefore seems essential to rigorously study these modifications, as they have been studied in the past for ARDS. The aim of this non-interventional study is to describe precisely the respiratory and hemodynamic changes induced by COVID-19 in mechanically ventilated patients .

Official Title
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Respiratory and Hemodynamic Changes Induced in Mechanically Ventilated Patients for COVID-19

Conditions
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COVID-19, ARDS, Sars-CoV2

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: hospitalized in intensive care for a SARS-CoV2 infection requiring invasive ventilation, intubated for less than 72 hours with PaO2/FiO2 ratio < 200 mmHg Exclusion Criteria: Patient mechanically ventilated for 72 hours or more Patient with documented respiratory co-infection Patient with a contraindication to pulmonary artery catheter insertion: High risk of bleeding, pre-existing high degree of atrioventricular heart block , Pace Maker Patient with spontaneous ventilation Patient with severe ARDS with static compliance of the respiratory system < 20 mL/cmH2O Patient with severe ARDS with indication of prone positioning at inclusion. Patient with a cardiac condition that renders the measurement of pulmonary artery occlusion pressure uninterpretable as a surrogate for left ventricle end diastolic pressure (severe mitral insufficiency, severe mitral stricture, severe aortic insufficiency). Patient with intracardiac shunt Patient with ECMO Minors and pregnant women. Person not affiliated to or not benefiting from a social security scheme.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| intrapulmonary shunt ratio |  | during ICU stay, in the first 72 hours of mechanical ventilation initiation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evolution of respiratory variables | Evaluation of PaO2 variation between in a high level of PEEP (15cmH2O) and a low level of PEEP (5cmH2O) | during ICU stay, in the first 72 hours of mechanical ventilation initiation | 
| Evolution of respiratory variables | Evaluation of PaCO2 variation between in a high level of PEEP (15cmH2O) and a low level of PEEP (5cmH2O) | during ICU stay, in the first 72 hours of mechanical ventilation initiation | 
| Evolution of hemodynamic stability variables | Evaluation of cardiac output variation between a high level of PEEP (15cmH2O) and a low level of PEEP (5cmH2O) | during ICU stay, in the first 72 hours of mechanical ventilation initiation |