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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/61750
Title: Ventilation management and clinical outcomes in invasively ventilated patients with COVID-19 (PRoVENT-COVID): a national, multicentre, observational cohort study
Authors: Michela Botta
Anissa M. Tsonas
Janesh Pillay
Leonoor S. Boers
Anna Geke Algera
Lieuwe D.J. Bos
Dave A. Dongelmans
Marcus W. Hollmann
Janneke Horn
Alexander P.J. Vlaar
Marcus J. Schultz
Ary Serpa Neto
Frederique Paulus
Jesse P. van Akkeren
Cheetel K. Algoe
Rombout B. van Amstel
Onno L. Baur
Pablo van de Berg
Alida E. van den Berg
Dennis C.J.J. Bergmans
Dido I. van den Bersselaar
Freke A. Bertens
Alexander J.G.H. Bindels
Milou M. de Boer
Sylvia den Boer
Margriet Bogerd
Jennifer S. Breel
Hendrik de Bruin
Sanne de Bruin
Caro L. Bruna
Laura A. Buiteman-Kruizinga
Olaf L. Cremer
Rogier M. Determann
Willem Dieperink
Hildegard S. Franke
Michal S. Galek-Aldridge
Mart J. de Graaff
Laura A. Hagens
Jasper J. Haringman
Sebastiaan T. van der Heide
Pim L.J. van der Heiden
Nanon F.L. Heijnen
Stephan J.P. Hiel
Lotte L. Hoeijmakers
Liselotte Hol
Markus W. Hollmann
Marga E. Hoogendoorn
Robrecht van der Horst
Evy L.K. Ie
Dimitri P. Ivanov
Nicole Juffermans
Eline Kho
Eline S. de Klerk
Ankie W.M.M. Koopman-van Gemert
Matty Koopmans
Songul Kucukcelebi
Michael A. Kuiper
Dylan W. de Lange
Niels van Mourik
Sunny G.L.H. Nijbroek
Marisa Onrust
Evelien A.N. Oostdijk
Charlotte J. Pennartz
Luigi Pisani
Ilse M. Purmer
Thijs C.D. Rettig
Jan Paul Roozeman
Michiel T.U. Schuijt
Marcus J. Schultz
Ary Serpa Neto
Mengalvio E. Sleeswijk
Marry R. Smit
Peter E. Spronk
Willemke Stilma
Aart C. Strang
Pieter R. Tuinman
Christel M.A. Valk
Felicia L. Veen-Schra
Lars I. Veldhuis
Patricia van Velzen
Ward H. van der Ven
Peter van Vliet
Peter H.J. van der Voort
Louis van Welie
Henrico J.F.T. Wesselink
Hermien H. van der Wier-Lubbers
Bas van Wijk
Tineke Winters
Wing Yi Wong
Arthur R.H. van Zanten
Hogeschool van Amsterdam, University of Applied Sciences
University of Melbourne
Hospital Israelita Albert Einstein
Mahidol University
Nuffield Department of Medicine
University of Groningen, University Medical Center Groningen
Amsterdam UMC - University of Amsterdam
Keywords: Medicine
Issue Date: 1-Feb-2021
Citation: The Lancet Respiratory Medicine. Vol.9, No.2 (2021), 139-148
Abstract: © 2021 Elsevier Ltd Background: Little is known about the practice of ventilation management in patients with COVID-19. We aimed to describe the practice of ventilation management and to establish outcomes in invasively ventilated patients with COVID-19 in a single country during the first month of the outbreak. Methods: PRoVENT-COVID is a national, multicentre, retrospective observational study done at 18 intensive care units (ICUs) in the Netherlands. Consecutive patients aged at least 18 years were eligible for participation if they had received invasive ventilation for COVID-19 at a participating ICU during the first month of the national outbreak in the Netherlands. The primary outcome was a combination of ventilator variables and parameters over the first 4 calendar days of ventilation: tidal volume, positive end-expiratory pressure (PEEP), respiratory system compliance, and driving pressure. Secondary outcomes included the use of adjunctive treatments for refractory hypoxaemia and ICU complications. Patient-centred outcomes were ventilator-free days at day 28, duration of ventilation, duration of ICU and hospital stay, and mortality. PRoVENT-COVID is registered at ClinicalTrials.gov (NCT04346342). Findings: Between March 1 and April 1, 2020, 553 patients were included in the study. Median tidal volume was 6·3 mL/kg predicted bodyweight (IQR 5·7–7·1), PEEP was 14·0 cm H2O (IQR 11·0–15·0), and driving pressure was 14·0 cm H2O (11·2–16·0). Median respiratory system compliance was 31·9 mL/cm H2O (26·0–39·9). Of the adjunctive treatments for refractory hypoxaemia, prone positioning was most often used in the first 4 days of ventilation (283 [53%] of 530 patients). The median number of ventilator-free days at day 28 was 0 (IQR 0–15); 186 (35%) of 530 patients had died by day 28. Predictors of 28-day mortality were gender, age, tidal volume, respiratory system compliance, arterial pH, and heart rate on the first day of invasive ventilation. Interpretation: In patients with COVID-19 who were invasively ventilated during the first month of the outbreak in the Netherlands, lung-protective ventilation with low tidal volume and low driving pressure was broadly applied and prone positioning was often used. The applied PEEP varied widely, despite an invariably low respiratory system compliance. The findings of this national study provide a basis for new hypotheses and sample size calculations for future trials of invasive ventilation for COVID-19. These data could also help in the interpretation of findings from other studies of ventilation practice and outcomes in invasively ventilated patients with COVID-19. Funding: Amsterdam University Medical Centers, location Academic Medical Center.
URI: http://repository.li.mahidol.ac.th/dspace/handle/123456789/61750
metadata.dc.identifier.url: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85096368082&origin=inward
ISSN: 22132619
22132600
Appears in Collections:Scopus 2021

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