Publication: Associations of body mass index with ventilation management and clinical outcomes in invasively ventilated patients with ards related to covid-19—insights from the provent-covid study
Issued Date
2021-03-02
Resource Type
ISSN
20770383
Other identifier(s)
2-s2.0-85113931479
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Clinical Medicine. Vol.10, No.6 (2021), 1-14
Suggested Citation
Renée Schavemaker, Marcus J. Schultz, Wim K. Lagrand, Eline R. van Slobbe-Bijlsma, Ary Serpa Neto, Frederique Paulus Associations of body mass index with ventilation management and clinical outcomes in invasively ventilated patients with ards related to covid-19—insights from the provent-covid study. Journal of Clinical Medicine. Vol.10, No.6 (2021), 1-14. doi:10.3390/jcm10061176 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/78358
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Associations of body mass index with ventilation management and clinical outcomes in invasively ventilated patients with ards related to covid-19—insights from the provent-covid study
Abstract
We describe the practice of ventilation and mortality rates in invasively ventilated normal-weight (18.5 ≤ BMI ≤ 24.9 kg/m2), overweight (25.0 ≤ BMI ≤ 29.9 kg/m2), and obese (BMI > 30 kg/m2) COVID-19 ARDS patients in a national, multicenter observational study, performed at 22 intensive care units in the Netherlands. The primary outcome was a combination of ventilation variables and parameters over the first four calendar days of ventilation, including tidal volume, positive end– expiratory pressure (PEEP), respiratory system compliance, and driving pressure in normal–weight, overweight, and obese patients. Secondary outcomes included the use of adjunctive treatments for refractory hypoxaemia and mortality rates. Between 1 March 2020 and 1 June 2020, 1122 patients were included in the study: 244 (21.3%) normal-weight patients, 531 (47.3%) overweight patients, and 324 (28.8%) obese patients. Most patients received a tidal volume < 8 mL/kg PBW; only on the first day was the tidal volume higher in obese patients. PEEP and driving pressure were higher, and compliance of the respiratory system was lower in obese patients on all four days. Adjunctive therapies for refractory hypoxemia were used equally in the three BMI groups. Adjusted mortality rates were not different between BMI categories. The findings of this study suggest that lung-protective ventilation with a lower tidal volume and prone positioning is similarly feasible in normal-weight, overweight, and obese patients with ARDS related to COVID-19. A patient’s BMI should not be used in decisions to forgo or proceed with invasive ventilation.