Publication:
Association of intensity of ventilation with 28-day mortality in COVID-19 patients with acute respiratory failure: insights from the PRoVENT-COVID study

Issued Date

2021-12-01

Resource Type

Article

ISSN

1466609X
13648535

DOI

10.1186/s13054-021-03710-6

Other identifier(s)

2-s2.0-85113177921

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Critical Care. Vol.25, No.1 (2021)

Suggested Citation

Michiel T.U. Schuijt, Marcus J. Schultz, Frederique Paulus, Ary Serpa Neto, J. P. van Akkeren, A. G. Algera, C. K. Algoe, R. B. van Amstel, O. L. Baur, P. van de Berg, D. C.J.J. Bergmans, D. I. van den Bersselaar, F. A. Bertens, A. J.G.H. Bindels, M. M. de Boer, S. den Boer, L. S. Boers, M. Bogerd, L. D.J. Bos, M. Botta, J. S. Breel, H. de Bruin, S. de Bruin, C. L. Bruna, L. A. Buiteman-Kruizinga, O. Cremer, R. M. Determann, W. Dieperink, D. A. Dongelmans, H. S. Franke, M. S.Galek Aldridge, M. J. de Graaff, L. A. Hagens, J. J. Haringman, N. F.L. Heijnen, S. Hiel, S. T. van der Heide, P. L.J. van der Heiden, L. L. Hoeijmakers, L. Hol, M. W. Hollmann, M. E. Hoogendoorn, J. Horn, R. van der Horst, E. L.K. Ie, D. Ivanov, N. P. Juffermans, E. Kho, E. S. de Klerk, A. W.M. Koopman, M. Koopmans, S. Kucukcelebi, M. A. Kuiper, D. W. de Lange, D. M. van Meenen, Ignacio Martin-Loeches, Guido Mazzinari, N. van Mourik, S. G. Nijbroek, M. Onrust, E. A.N. Oostdijk, F. Paulus, C. J. Pennartz, J. Pillay, L. Pisani, I. M. Purmer, T. C.D. Rettig, J. P. Roozeman, M. J. Schultz, A. Serpa Neto, M. E. Sleeswijk, M. R. Smit, P. E. Spronk, W. Stilma, A. C. Strang, A. M. Tsonas, P. R. Tuinman, C. M.A. Valk, F. L. Veen, A. P.J. Vlaar, L. I. Veldhuis, P. van Velzen, W. H. van der Ven, P. van Vliet, P. van der Voort, H. H. van der Wier, L. van Welie, H. J.F.T. Wesselink, B. van Wijk, T. Winters, W. Y. Wong, A. R.H. van Zanten Association of intensity of ventilation with 28-day mortality in COVID-19 patients with acute respiratory failure: insights from the PRoVENT-COVID study. Critical Care. Vol.25, No.1 (2021). doi:10.1186/s13054-021-03710-6 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77545

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Title

Association of intensity of ventilation with 28-day mortality in COVID-19 patients with acute respiratory failure: insights from the PRoVENT-COVID study

Author(s)

Michiel T.U. Schuijt
 Marcus J. Schultz
 Frederique Paulus
 Ary Serpa Neto
 J. P. van Akkeren
 A. G. Algera
 C. K. Algoe
 R. B. van Amstel
 O. L. Baur
 P. van de Berg
 D. C.J.J. Bergmans
 D. I. van den Bersselaar
 F. A. Bertens
 A. J.G.H. Bindels
 M. M. de Boer
 S. den Boer
 L. S. Boers
 M. Bogerd
 L. D.J. Bos
 M. Botta
 J. S. Breel
 H. de Bruin
 S. de Bruin
 C. L. Bruna
 L. A. Buiteman-Kruizinga
 O. Cremer
 R. M. Determann
 W. Dieperink
 D. A. Dongelmans
 H. S. Franke
 M. S.Galek Aldridge
 M. J. de Graaff
 L. A. Hagens
 J. J. Haringman
 N. F.L. Heijnen
 S. Hiel
 S. T. van der Heide
 P. L.J. van der Heiden
 L. L. Hoeijmakers
 L. Hol
 M. W. Hollmann
 M. E. Hoogendoorn
 J. Horn
 R. van der Horst
 E. L.K. Ie
 D. Ivanov
 N. P. Juffermans
 E. Kho
 E. S. de Klerk
 A. W.M. Koopman
 M. Koopmans
 S. Kucukcelebi
 M. A. Kuiper
 D. W. de Lange
 D. M. van Meenen
 Ignacio Martin-Loeches
 Guido Mazzinari
 N. van Mourik
 S. G. Nijbroek
 M. Onrust
 E. A.N. Oostdijk
 F. Paulus
 C. J. Pennartz
 J. Pillay
 L. Pisani
 I. M. Purmer
 T. C.D. Rettig
 J. P. Roozeman
 M. J. Schultz
 A. Serpa Neto
 M. E. Sleeswijk
 M. R. Smit
 P. E. Spronk
 W. Stilma
 A. C. Strang
 A. M. Tsonas
 P. R. Tuinman
 C. M.A. Valk
 F. L. Veen
 A. P.J. Vlaar
 L. I. Veldhuis
 P. van Velzen
 W. H. van der Ven
 P. van Vliet
 P. van der Voort
 H. H. van der Wier
 L. van Welie
 H. J.F.T. Wesselink
 B. van Wijk
 T. Winters
 W. Y. Wong
 A. R.H. van Zanten

Other Contributor(s)

Hogeschool van Amsterdam, University of Applied Sciences
 Monash University
 Mahidol University
 Nuffield Department of Medicine
 Amsterdam UMC - University of Amsterdam

Abstract

Background: The intensity of ventilation, reflected by driving pressure (ΔP) and mechanical power (MP), has an association with outcome in invasively ventilated patients with or without acute respiratory distress syndrome (ARDS). It is uncertain if a similar association exists in coronavirus disease 2019 (COVID-19) patients with acute respiratory failure. Methods: We aimed to investigate the impact of intensity of ventilation on patient outcome. The PRoVENT-COVID study is a national multicenter observational study in COVID-19 patients receiving invasive ventilation. Ventilator parameters were collected a fixed time points on the first calendar day of invasive ventilation. Mean dynamic ΔP and MP were calculated for individual patients at time points without evidence of spontaneous breathing. A Cox proportional hazard model, and a double stratification analysis adjusted for confounders were used to estimate the independent associations of ΔP and MP with outcome. The primary endpoint was 28-day mortality. Results: In 825 patients included in this analysis, 28-day mortality was 27.5%. ΔP was not independently associated with mortality (HR 1.02 [95% confidence interval 0.88–1.18]; P = 0.750). MP, however, was independently associated with 28-day mortality (HR 1.17 [95% CI 1.01–1.36]; P = 0.031), and increasing quartiles of MP, stratified on comparable levels of ΔP, had higher risks of 28-day mortality (HR 1.15 [95% CI 1.01–1.30]; P = 0.028). Conclusions: In this cohort of critically ill invasively ventilated COVID-19 patients with acute respiratory failure, we show an independent association of MP, but not ΔP with 28-day mortality. MP could serve as one prognostic biomarker in addition to ΔP in these patients. Efforts aiming at limiting both ΔP and MP could translate in a better outcome. Trial registration Clinicaltrials.gov (study identifier NCT04346342). [Figure not available: see fulltext.]

Keyword(s)

Medicine

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https://repository.li.mahidol.ac.th/handle/20.500.14594/77545

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Scopus 2021