The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

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 ad...

Descripción completa

Detalles Bibliográficos
Autores: Torres Martí, Antoni, Marin Corral, Judith, Barbé, Ferran, CIBERESUCICOVID Project (COV20/00110, ISCIII)
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/53318
Acceso en línea:http://hdl.handle.net/10230/53318
http://dx.doi.org/10.1186/s13054-021-03727-x
Access Level:acceso abierto
Palabra clave:COVID-19
Coronavirus
Mechanical ventilation
SARS-CoV-2
Ventilatory ratio
id ES_a0db2a80e49c7a19db55a2f7139c8596
oai_identifier_str oai:recercat.cat:10230/53318
network_acronym_str ES
network_name_str España
spelling The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients Torres Martí, Antoni Marin Corral, Judith Barbé, Ferran CIBERESUCICOVID Project (COV20/00110, ISCIII) COVID-19 Coronavirus Mechanical ventilation SARS-CoV-2 Ventilatory ratio 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, PaO2/FiO2 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 PaO2/FiO2 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 PaO2/FiO2 variation. BioMed Central http://hdl.handle.net/10230/53318 http://dx.doi.org/10.1186/s13054-021-03727-x
title The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
spellingShingle The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
Torres Martí, Antoni
COVID-19
Coronavirus
Mechanical ventilation
SARS-CoV-2
Ventilatory ratio
title_short The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
title_full The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
title_fullStr The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
title_full_unstemmed The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
title_sort The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
author Torres Martí, Antoni
author_facet Torres Martí, Antoni
Marin Corral, Judith
Barbé, Ferran
CIBERESUCICOVID Project (COV20/00110, ISCIII)
author_role author
author2 Marin Corral, Judith
Barbé, Ferran
CIBERESUCICOVID Project (COV20/00110, ISCIII)
author2_role author
author
author
topic COVID-19
Coronavirus
Mechanical ventilation
SARS-CoV-2
Ventilatory ratio
topic_facet COVID-19
Coronavirus
Mechanical ventilation
SARS-CoV-2
Ventilatory ratio
description 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, PaO2/FiO2 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 PaO2/FiO2 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 PaO2/FiO2 variation.
publishDate 2021
format article
status_str publishedVersion
url http://hdl.handle.net/10230/53318
http://dx.doi.org/10.1186/s13054-021-03727-x
eu_rights_str_mv openAccess
publisher BioMed Central
institution Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
collection Recercat. Dipósit de la Recerca de Catalunya
reponame_str Recercat. Dipósit de la Recerca de Catalunya
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
_version_ 1878438646487449600
publishDateSort 2021
author_browse Barbé, Ferran
CIBERESUCICOVID Project (COV20/00110, ISCIII)
Marin Corral, Judith
Torres Martí, Antoni
publisherStr BioMed Central
score 6,9303427

Similares en LA Referencia