Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID era
Issued Date
2024-12-01
Resource Type
ISSN
14659921
eISSN
1465993X
Scopus ID
2-s2.0-85201538947
Journal Title
Respiratory Research
Volume
25
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Respiratory Research Vol.25 No.1 (2024)
Suggested Citation
van der Ven F.L.I.M., Blok S.G., Azevedo L.C., Bellani G., Botta M., Estenssoro E., Fan E., Ferreira J.C., Laffey J.G., Martin–Loeches I., Motos A., Pham T., Peñuelas O., Pesenti A., Pisani L., Neto A.S., Schultz M.J., Torres A., Tsonas A.M., Paulus F., van Meenen D.M.P. Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID era. Respiratory Research Vol.25 No.1 (2024). doi:10.1186/s12931-024-02910-2 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/100617
Title
Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID era
Author's Affiliation
Mahidol Oxford Tropical Medicine Research Unit
Université Paris-Saclay
Hogeschool van Amsterdam, University of Applied Sciences
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Red Cross Hospital, Beverwijk
Ospedale S. Chiara
University Hospital Galway
Institució Catalana de Recerca i Estudis Avançats
Hospital Clínic de Barcelona
University of Toronto Faculty of Medicine
A.C.Camargo Cancer Center
Monash University
Hospital Israelita Albert Einstein
Università di Trento
Hopital de Bicetre
Medizinische Universität Wien
Nuffield Department of Medicine
University of Galway
Universidade de São Paulo
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
Hospital Universitario de Getafe
St James's Hospital
Universitat de Barcelona
Amsterdam UMC - University of Amsterdam
Brazilian Research in Intensive Care Network (BRICNet)
Miulli Regional Hospital
Hospital Interzonal de Agudos San Martin de la Plata
Université Paris-Saclay
Hogeschool van Amsterdam, University of Applied Sciences
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Red Cross Hospital, Beverwijk
Ospedale S. Chiara
University Hospital Galway
Institució Catalana de Recerca i Estudis Avançats
Hospital Clínic de Barcelona
University of Toronto Faculty of Medicine
A.C.Camargo Cancer Center
Monash University
Hospital Israelita Albert Einstein
Università di Trento
Hopital de Bicetre
Medizinische Universität Wien
Nuffield Department of Medicine
University of Galway
Universidade de São Paulo
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
Hospital Universitario de Getafe
St James's Hospital
Universitat de Barcelona
Amsterdam UMC - University of Amsterdam
Brazilian Research in Intensive Care Network (BRICNet)
Miulli Regional Hospital
Hospital Interzonal de Agudos San Martin de la Plata
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Ventilation management may differ between COVID–19 ARDS (COVID–ARDS) patients and patients with pre–COVID ARDS (CLASSIC–ARDS); it is uncertain whether associations of ventilation management with outcomes for CLASSIC–ARDS also exist in COVID–ARDS. Methods: Individual patient data analysis of COVID–ARDS and CLASSIC–ARDS patients in six observational studies of ventilation, four in the COVID–19 pandemic and two pre–pandemic. Descriptive statistics were used to compare epidemiology and ventilation characteristics. The primary endpoint were key ventilation parameters; other outcomes included mortality and ventilator–free days and alive (VFD–60) at day 60. Results: This analysis included 6702 COVID–ARDS patients and 1415 CLASSIC–ARDS patients. COVID–ARDS patients received lower median VT (6.6 [6.0 to 7.4] vs 7.3 [6.4 to 8.5] ml/kg PBW; p < 0.001) and higher median PEEP (12.0 [10.0 to 14.0] vs 8.0 [6.0 to 10.0] cm H2O; p < 0.001), at lower median ΔP (13.0 [10.0 to 15.0] vs 16.0 [IQR 12.0 to 20.0] cm H2O; p < 0.001) and higher median Crs (33.5 [26.6 to 42.1] vs 28.1 [21.6 to 38.4] mL/cm H2O; p < 0.001). Following multivariable adjustment, higher ΔP had an independent association with higher 60–day mortality and less VFD–60 in both groups. Higher PEEP had an association with less VFD–60, but only in COVID–ARDS patients. Conclusions: Our findings show important differences in key ventilation parameters and associations thereof with outcomes between COVID–ARDS and CLASSIC–ARDS. Trial registration: Clinicaltrials.gov (identifier NCT05650957), December 14, 2022.