biostudies-literatureBastia LCanadian Institutes of Health ResearchCIHR35https://www.ebi.ac.uk/biostudies/studies/S-EPMC9003155biostudies-literatureUnknown12(1)<h4>Background</h4>External chest-wall compression (ECC) is sometimes used in ARDS patients despite lack of evidence. It is currently unknown whether this practice has any clinical benefit in patients with COVID-19 ARDS (C-ARDS) characterized by a respiratory system compliance (C_rs) < 35 mL/cmH₂O.<h4>Objectives</h4>To test if an ECC with a 5 L-bag in low-compliance C-ARDS can lead to a reduction in driving pressure (DP) and improve gas exchange, and to understand the underlying mechanisms.<h4>Methods</h4>Eleven patients with low-compliance C-ARDS were enrolled and underwent 4 steps: baseline, ECC for 60 min, ECC discontinuation and PEEP reduction. Respiratory mechanics, gas exchange, hemodynamics and electrical impedance tomography were recorded. Four pigs with acute Annals of intensive careExternal chest-wall compression in prolonged COVID-19 ARDS with low-compliance: a physiological study.PMC9003155PJT152898PJT156336Forlini CBrochard LJFumagalli REngelberts DLanger TSpina SMarrazzo FBellani GPost MBassi GGiudici RRezoagli EGuarnieri MBastia LfalseExternal chest-wall compression in prolonged COVID-19 ARDS with low-compliance: a physiological study.<h4>Background</h4>External chest-wall compression (ECC) is sometimes used in ARDS patients despite lack of evidence. It is currently unknown whether this practice has any clinical benefit in patients with COVID-19 ARDS (C-ARDS) characterized by a respiratory system compliance (C_rs) < 35 mL/cmH₂O.<h4>Objectives</h4>To test if an ECC with a 5 L-bag in low-compliance C-ARDS can lead to a reduction in driving pressure (DP) and improve gas exchange, and to understand the underlying mechanisms.<h4>Methods</h4>Eleven patients with low-compliance C-ARDS were enrolled and underwent 4 steps: baseline, ECC for 60 min, ECC discontinuation and PEEP reduction. Respiratory mechanics, gas exchange, hemodynamics and electrical impedance tomography were recorded. Four pigs with acute 2022-01-01T00:00:00Z2022 Apr2026-07-14T14:43:45.462Z2026-06-20T03:11:15.363ZS-EPMC90031553541216110.1186/s13613-022-01008-6