A physiological approach to understand the role of respiratory effort in the progression of lung injury in SARS-CoV-2 infection
Pablo Cruces, Jaime Retamal, Daniel E. Hurtado, Benjamín Erranz, Pablo Iturrieta, Carlos González, Franco Díaz
Abstract
Deterioration of lung function during the first week of COVID-19 has been observed when patients remain with insufficient respiratory support. Patient self-inflicted lung injury (P-SILI) is theorized as the responsible, but there is not robust experimental and clinical data to support it. Given the limited understanding of P-SILI, we describe the physiological basis of P-SILI and we show experimental data to comprehend the role of regional strain and heterogeneity in lung injury due to increased work of breathing.In addition, we discuss the current approach to respiratory support for COVID-19 under this point of view.
Topics & Concepts
MedicineCoronavirus disease 2019 (COVID-19)Respiratory systemLungLung functionIntensive care medicineSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Respiratory physiologyInternal medicineDiseaseInfectious disease (medical specialty)Respiratory Support and MechanismsCardiac Arrest and ResuscitationIntensive Care Unit Cognitive Disorders