Publication:
Ventilation management and clinical outcomes in invasively ventilated patients with COVID-19 (PRoVENT-COVID): a national, multicentre, observational cohort study

Issued Date

2021-02-01

Resource Type

Article

ISSN

22132619
22132600

DOI

10.1016/S2213-2600(20)30459-8

Other identifier(s)

2-s2.0-85096368082

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

The Lancet Respiratory Medicine. Vol.9, No.2 (2021), 139-148

Suggested Citation

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, 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 Ventilation management and clinical outcomes in invasively ventilated patients with COVID-19 (PRoVENT-COVID): a national, multicentre, observational cohort study. The Lancet Respiratory Medicine. Vol.9, No.2 (2021), 139-148. doi:10.1016/S2213-2600(20)30459-8 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78502

Research Projects

Organizational Units

Authors

Journal Issue

Thesis

Title

Ventilation management and clinical outcomes in invasively ventilated patients with COVID-19 (PRoVENT-COVID): a national, multicentre, observational cohort study

Author(s)

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
 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

Other Contributor(s)

Hogeschool van Amsterdam, University of Applied Sciences
 University of Melbourne
 Hospital Israelita Albert Einstein
 Mahidol University
 Nuffield Department of Medicine
 Universitair Medisch Centrum Groningen
 Amsterdam UMC - University of Amsterdam

Abstract

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.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/78502

Collections

Scopus 2021