When subdivided in four groups based on cut-off PaO 2/FiO 2 of 150 mmHg and compliance of 40 mL/cmH 2O 72% ( n = 154) had PaO 2/FiO 2 150 mmHg, patients with PaO 2/FiO 2 < 150 mmHg had higher estimated physiological dead space fraction (Fig. Continuous variables were compared using Mann–Whitney U test. We used the recorded values at the time of worst PaO 2/FiO 2 observed on the day of critical care admission. To describe estimated indices of physiological dead space-and their association with respiratory mechanics, severity of hypoxaemia, biomarkers, and outcomes-we performed a retrospective analysis of adult patients with COVID-19 respiratory failure requiring mechanical ventilation in four medical Intensive Care Units (ICU) within Guy’s and St Thomas’ NHS Trust-London, UK (Ethics reference: 10,796). The alteration of the pulmonary vascular tone and immune thrombosis of the alveolar capillaries may account for these pathophysiological characteristics and for the high physiological dead space observed in these patients. The severity of acute hypoxemic respiratory failure (AHRF) in Coronavirus Disease 2019 (COVID-19) correlates poorly with lung weight and lung mechanics, leading to the proposal of phenotypes that may be associated with similar degree of hypoxaemia but different lung volume, weight, and compliance.
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