학술논문
Noninvasive ventilation in COVID-19 patients aged [greater than or equal to] 70 years--a prospective multicentre cohort study
Document Type
Report
Author
Polok, Kamil; Fronczek, Jakub; Artigas, Antonio; Flaatten, Hans; Guidet, Bertrand; De Lange, Dylan W.; Fjalner, Jesper; Leaver, Susannah; Beil, Michael; Sviri, Sigal; Bruno, Raphael Romano; Wernly, Bernhard; Bollen Pinto, Bernardo; Schefold, Joerg C.; StudziÅska, Dorota; Joannidis, Michael; Oeyen, Sandra; Marsh, Brian; Andersen, Finn H.; Moreno, Rui; Cecconi, Maurizio; Jung, Christian; Szczeklik, Wojciech; Eller, Philipp; Mesotten, Dieter; Reper, Pascal; Swinnen, Walter; Brix, Helene; Brushoej, Jens; Villefrance, Maja; Nedergaard, Helene Korvenius; Bjerregaard, Anders Thais; Balleby, Ida Riise; Andersen, Kasper; Hansen, Maria Aagaard; Uhrenholt, Stine; Bundgaard, Helle; Hussein, Aliae A. R. Mohamed; Salah, Rehab; Ali, Yasmin Khairy NasrEldin Mohamed; Wassim, Kyrillos; Elgazzar, Yumna A.; Tharwat, Samar; Azzam, Ahmed Y.; habib, Ayman abdelmawgoad; Abosheaishaa, Hazem Maarouf; Azab, Mohammed A.; Galbois, Arnaud; Charron, Cyril; Guerot, Emmanuel; Besch, Guillaume; Rigaud, Jean-Philippe; Maizel, Julien; Djibré, Michel; Burtin, Philippe; Garcon, Pierre; Nseir, Saad; Valette, Xavier; Alexandru, Nica; Marin, Nathalie; Vaissiere, Marie; Plantefeve, Gaëtan; Vanderlinden, Thierry; Jurcisin, Igor; Megarbane, Buno; Caillard, Anais; Valent, Arnaud; Garnier, Marc; Besset, Sebastien; Oziel, Johanna; RAPHALEN, Jean-herlé; Dauger, Stéphane; Dumas, Guillaume; Goncalves, Bruno; Piton, Gaël; Barth, Eberhard; Goebel, Ulrich; Kunstein, Anselm; Schuster, Michael; Welte, Martin; Lutz, Matthias; Meybohm, Patrick; Steiner, Stephan; Poerner, Tudor; Haake, Hendrik; Schaller, Stefan; Kindgen-Milles, Detlef; Meyer, Christian; Kurt, Muhammed; Kuhn, Karl Friedrich; Randerath, Winfried; Wollborn, Jakob; Dindane, Zouhir; Kabitz, Hans-Joachim; Voigt, Ingo; Shala, Gonxhe; Faltlhauser, Andreas; Rovina, Nikoletta; Aidoni, Zoi; Chrisanthopoulou, Evangelia; Papadogoulas, Antonios; Gurjar, Mohan; Mahmoodpoor, Ata; Ahmed, Abdullah khudhur; Elsaka, Ahmed; Comellini, Vittoria; Rabha, Ahmed; Ahmed, Hazem; Namendys-Silva, Silvio A.; Ghannam, Abdelilah; Groenendijk, Martijn; Zegers, Marieke; de Lange, Dylan; Cornet, Alex; Evers, Mirjam; Haas, Lenneke; Dormans, Tom; Dieperink, Willem; Romundstad, Luis; Sjaba, Britt; Strietzel, Hans Frank; Olasveengen, Theresa; Hahn, Michael; Czuczwar, Miroslaw; Gawda, Ryszard; Klimkiewicz, Jakub; de Lurdes Campos Santos, Maria; Gordinho, André; Santos, Henrique; Assis, Rui; Oliveira, Ana Isabel Pinho; Badawy, Mohamed Raafat; Perez-Torres, David; Gomà, Gemma; Villamayor, Mercedes Ibarz; Mira, Angela Prado; Cubero, Patricia Jimeno; Rivera, Susana Arias; Tomasa, Teresa; Iglesias, David; Vázquez, Eric Mayor; Aldecoa, Cesar; Ferreira, Aida Fernández; Zalba-Etayo, Begoéa; Canas-Perez, Isabel; Tamayo-Lomas, Luis; Diaz-Rodriguez, Cristina; Sancho, Susana; Priego, Jesús; Abualqumboz, Enas M. Y.; Hilles, Momin Majed Yousuf; Saleh, Mahmoud; Ben-HAmouda, Nawfel; Roberti, Andrea; Dullenkopf, Alexander; Fleury, Yvan; Al-Sadawi, Mohammed
Source
Critical Care. July 22, 2022, Vol. 26 Issue 1
Subject
Language
English
ISSN
1364-8535
Abstract
Author(s): Kamil Polok[sup.1,2] , Jakub Fronczek[sup.1] , Antonio Artigas[sup.3] , Hans Flaatten[sup.4,5] , Bertrand Guidet[sup.6,7] , Dylan W. De Lange[sup.8] , Jesper Fjalner[sup.9] , Susannah Leaver[sup.10] , Michael Beil[sup.11] , [...]
Background Noninvasive ventilation (NIV) is a promising alternative to invasive mechanical ventilation (IMV) with a particular importance amidst the shortage of intensive care unit (ICU) beds during the COVID-19 pandemic. We aimed to evaluate the use of NIV in Europe and factors associated with outcomes of patients treated with NIV. Methods This is a substudy of COVIP study--an international prospective observational study enrolling patients aged [greater than or equal to] 70 years with confirmed COVID-19 treated in ICU. We enrolled patients in 156 ICUs across 15 European countries between March 2020 and April 2021.The primary endpoint was 30-day mortality. Results Cohort included 3074 patients, most of whom were male (2197/3074, 71.4%) at the mean age of 75.7 years (SD 4.6). NIV frequency was 25.7% and varied from 1.1 to 62.0% between participating countries. Primary NIV failure, defined as need for endotracheal intubation or death within 30 days since ICU admission, occurred in 470/629 (74.7%) of patients. Factors associated with increased NIV failure risk were higher Sequential Organ Failure Assessment (SOFA) score (OR 3.73, 95% CI 2.36-5.90) and Clinical Frailty Scale (CFS) on admission (OR 1.46, 95% CI 1.06-2.00). Patients initially treated with NIV (n = 630) lived for 1.36 fewer days (95% CI - 2.27 to - 0.46 days) compared to primary IMV group (n = 1876). Conclusions Frequency of NIV use varies across European countries. Higher severity of illness and more severe frailty were associated with a risk of NIV failure among critically ill older adults with COVID-19. Primary IMV was associated with better outcomes than primary NIV. Clinical Trial RegistrationNCT04321265, registered 19 March 2020, https://clinicaltrials.gov. Keywords: COVID-19, Noninvasive ventilation, Frailty, Intensive care unit, Elderly
Background Noninvasive ventilation (NIV) is a promising alternative to invasive mechanical ventilation (IMV) with a particular importance amidst the shortage of intensive care unit (ICU) beds during the COVID-19 pandemic. We aimed to evaluate the use of NIV in Europe and factors associated with outcomes of patients treated with NIV. Methods This is a substudy of COVIP study--an international prospective observational study enrolling patients aged [greater than or equal to] 70 years with confirmed COVID-19 treated in ICU. We enrolled patients in 156 ICUs across 15 European countries between March 2020 and April 2021.The primary endpoint was 30-day mortality. Results Cohort included 3074 patients, most of whom were male (2197/3074, 71.4%) at the mean age of 75.7 years (SD 4.6). NIV frequency was 25.7% and varied from 1.1 to 62.0% between participating countries. Primary NIV failure, defined as need for endotracheal intubation or death within 30 days since ICU admission, occurred in 470/629 (74.7%) of patients. Factors associated with increased NIV failure risk were higher Sequential Organ Failure Assessment (SOFA) score (OR 3.73, 95% CI 2.36-5.90) and Clinical Frailty Scale (CFS) on admission (OR 1.46, 95% CI 1.06-2.00). Patients initially treated with NIV (n = 630) lived for 1.36 fewer days (95% CI - 2.27 to - 0.46 days) compared to primary IMV group (n = 1876). Conclusions Frequency of NIV use varies across European countries. Higher severity of illness and more severe frailty were associated with a risk of NIV failure among critically ill older adults with COVID-19. Primary IMV was associated with better outcomes than primary NIV. Clinical Trial RegistrationNCT04321265, registered 19 March 2020, https://clinicaltrials.gov. Keywords: COVID-19, Noninvasive ventilation, Frailty, Intensive care unit, Elderly