학술논문
The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
acute respiratory distress syndrome
acute respiratory distress syndrome
Document Type
Report
Author
Torres, Antoni; Motos, Anna; Riera, Jordi; Fernández-Barat, Laia; Ceccato, Adrián; Pérez-Arnal, Raquel; García-Gasulla, Dario; Peéuelas, Oscar; Lorente, José Angel; Rodriguez, Alejandro; de Gonzalo-Calvo, David; Almansa, Raquel; Gabarrús, Albert; Menéndez, Rosario; Bermejo-Martin, Jesús F.; Ferrer, Ricard; Amaya Villar, Rosario; Aéón, José M.; Barberà, Carme; Barberán, José; Blandino Ortiz, Aaron; Bustamante-Munguira, Elena; Caballero, Jesús; Carbajales, Cristina; Carbonell, Nieves; Catalán-González, Mercedes; Galbán, Cristóbal; Gumucio-Sanguino, Víctor D.; de la Torre, Maria del Carmen; Díaz, Emili; Estella, Ãngel; Gallego, Elena; García Garmendia, José Luis; Garnacho-Montero, José; Gómez, José M.; Huerta, Arturo; Jorge García, Ruth Noemí; Loza-Vázquez, Ana; Marin-Corral, Judith; Martínez de la Gándara, Amalia; Martínez Varela, Ignacio; López Messa, Juan; M. Albaiceta, Guillermo; Novo, Mariana Andrea; Peéasco, Yhivian; Pozo-Laderas, Juan Carlos; Ricart, Pilar; Salvador-Adell, Inmaculada; Sánchez-Miralles, Angel; Sancho Chinesta, Susana; Socias, Lorenzo; Solé-Violan, Jordi; Suares Sipmann, Fernando; Tamayo Lomas, Luis; Trenado, José; Barbé, Ferran; Adell-Serrano, Berta; Agrifoglio, Alexander; Aguilar Cabello, María; Aguilera, Luciano; Alcaraz-Serrano, Victoria; Aldecoa, Cesar; Alegre, Cynthia; Ãlvarez, Sergio; Ãlvarez Ruiz, Antonjo; Andrea, Rut; Ãngel, José; Arrieta, Marta; Ayestarán, J. Ignacio; Badia, Joan Ramon; Badía, Mariona; Báez Pravia, Orville; Mariéo, Ana Balan; Balsera, Begoéa; Barbena, Laura; Barbeta, Enric; Bardi, Tommaso; Barral Segade, Patricia; Barroso, Marta; Berezo García, José Ãngel; Bigas, Judit; Blancas, Rafael; Blasco Cortés, María Luisa; Boado, María; Bodi Saera, María; Bofill, Neus; Bouza Vieiro, María Teresa; Bueno, Leticia; Bustamante-Munguira, Juan; Cachafeiro, Lucia; Campi Hermoso, David; Campos Fernández, Sandra; Cano, Iosune; Cantón-Bulnes, Maria Luisa; Cardina Fernández, Pablo; Carrión García, Laura; Carvalho, Sula; Casacuberta-Barberà, Núria; Castellà, Manuel; Castellví, Andrea; Castro, Pedro; Cicuendez Ãvila, Ramon; Cillóniz, Catia; Clar, Luisa; Climent, Cristina; Codina, Jordi; Conde, Pamela; Contreras, Sofía; Martin, María Cruz; de Pablo Sánchez, Raul; De Mendoza, Diego; del Busto Martínez, Cecilia; Díaz, Yolanda; Rivas Vilas, María Digna; Dólera Moreno, Cristina; Dot, Irene; Enríquez Giraudo, Pedro; Esmorís Arijón, Inés; Farre Monjo, Teresa; Fernández, Javier; Ferrando, Carlos; Figueras, Albert; Forcadell-Ferreres, Eva; Forcelledo Espina, Lorena; Franco, Nieves; Furro, Ãngels; García, Felipe; García, Beatriz; García Prieto, Emilio; García Redruello, Carlos; García Sagastume, Amaia; Gascón Castillo, Maria Luisa; Gomà, Gemma; Gómez Casal, Vanesa; Gómez, Silvia; Gómez Gonzalez, Carmen; González, Jessica; Gordo, Federico; Gracia, Maria Pilar; Herraiz, Alba; Herrán-Monge, Rubén; Ibarz, Mercedes; Iglesias, Silvia; Janer, Maria Teresa; Jiménez, Gabriel; Juan Díaz, Mar; Kiarostami, Karsa; Lazo Ãlvarez, Juan I.; León, Miguel; López-Gavín, Alexandre; López Lago, Ana; Macias Guerrero, Desire; Mamolar Herrera, Nuria; Maéez Mendiluce, Rafael; Mantellini, Cecilia L.; Marco Naya, Gregorio; Marcos, Pilar; Marmol Peis, Enrique; Martín Vicente, Paula; Martínez, María; Martínez Fernández, Carmen Eulalia; Martínez Juan, Maria Dolores; Masa Jimenez, Juan Fernando; Masclans, Joan Ramon; Maseda, Emilio; Menor Fernández, Eva María; Miralbés, Mar; Monclou, Josman; Montejo-González, Juan Carlos; Montserrat, Neus; Mora Aznar, María; Moral-Parras, Pedro; Morales, Dulce; Moreno Cano, Sara Guadalupe; Mosquera Rodríguez, David; Muéoz-Bermúdez, Rosana; Nicolás, José María; Nogue Bou, Ramon; Nogueras Salinas, Rafaela; Ocón, Marta; Ortega, Ana; Ossa, Sergio; Pagliarani, Pablo; Parera Pous, Anna; Parrilla, Francisco; Pérez Bastida, Leire; Pérez, Purificación; Pérez Planelles, Gloria; Rubio, Eva Pérez; Pestaéa Laguna, David; Piéol-Tena, Ãngels; Prados, Javier; Pujol, Andrés; Ramon Coll, Núria; Renedo Sanchez-Giron, Gloria; Roche-Campo, Ferran; Rodriguez, Laura; Rodríguez de Castro, Felipe; Rodríguez, Silvia; Rodríguez Ruiz, Covadonga; Rubio, Jorge; Rubio López, Alberto; Ruiz Miralles, Miriam; Ryan Murúa, Pablo; Saborido Paz, Eva; Salazar Degracia, Ana; Sanchez, Miguel; Sánchez, Ana; Santacoloma, Bitor; Sariéena, Maria Teresa; Segura Pensado, Marta; Serra, Lidia; Serra-Fortuny, Mireia; Serrano Lázaro, Ainhoa; Servià, Lluís; Soliva, Laura; Speziale, Carla; Tognetti, Daniel; Tormos, Adrián; Torres, Mateu; Trefler, Sandra; Trujillano, Javier; Ãbeda, Alejandro; Urrelo-Cerrón, Luis; Val, Estela; Valdivia Ruiz, Luis; Vallverdú, Montserrat; Van der Hofstadt Martin-Montalvo, Maria; Vara Adrio, Sabela; Vázquez, Nil; Vengoechea, Javier; Vidal Cortes, Pablo; Vilà-Vilardel, Clara; Vilanova, Judit; Villada Warrington, Tatiana; Yang, Hua; Yang, Minlan; Zapatero, Ana
Source
Critical Care. September 13, 2021, Vol. 25 Issue 1
Subject
Language
English
ISSN
1364-8535
Abstract
Author(s): Antoni Torres[sup.1,2,53] , Anna Motos[sup.1,2] , Jordi Riera[sup.3] , Laia Fernández-Barat[sup.1,2] , Adrián Ceccato[sup.1] , Raquel Pérez-Arnal[sup.4] , Dario García-Gasulla[sup.4] , Oscar Peéuelas[sup.1,5] , José Angel Lorente[sup.1,5] , Alejandro [...]
Background Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO.sub.2/FiO.sub.2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO.sub.2/FiO.sub.2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO.sub.2/FiO.sub.2 variation. Keywords: Ventilatory ratio, Mechanical ventilation, COVID-19, SARS-CoV-2, Coronavirus
Background Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO.sub.2/FiO.sub.2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO.sub.2/FiO.sub.2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO.sub.2/FiO.sub.2 variation. Keywords: Ventilatory ratio, Mechanical ventilation, COVID-19, SARS-CoV-2, Coronavirus