Hyperoxemia in invasively ventilated COVID–19 patients–Insights from the PRoVENT–COVID study
Issued Date
2022-01-01
Resource Type
ISSN
25310429
eISSN
25310437
Scopus ID
2-s2.0-85140756741
Pubmed ID
36274046
Journal Title
Pulmonology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Pulmonology (2022)
Suggested Citation
Tsonas A.M., van Meenen D.M., Botta M., Shrestha G.S., Roca O., Paulus F., Neto A.S., Schultz M.J. Hyperoxemia in invasively ventilated COVID–19 patients–Insights from the PRoVENT–COVID study. Pulmonology (2022). doi:10.1016/j.pulmoe.2022.09.003 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86264
Title
Hyperoxemia in invasively ventilated COVID–19 patients–Insights from the PRoVENT–COVID study
Author's Affiliation
Hogeschool van Amsterdam, University of Applied Sciences
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Tribhuvan University Teaching Hospital
Monash University
Hospital Israelita Albert Einstein
Mahidol University
Hospital Universitari Vall d'Hebron
Nuffield Department of Medicine
Austin Hospital
Amsterdam UMC
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Tribhuvan University Teaching Hospital
Monash University
Hospital Israelita Albert Einstein
Mahidol University
Hospital Universitari Vall d'Hebron
Nuffield Department of Medicine
Austin Hospital
Amsterdam UMC
Other Contributor(s)
Abstract
Objective: We determined the prevalences of hyperoxemia and excessive oxygen use, and the epidemiology, ventilation characteristics and outcomes associated with hyperoxemia in invasively ventilated patients with coronavirus disease 2019 (COVID–19). Methods: Post hoc analysis of a national, multicentre, observational study in 22 ICUs. Patients were classified in the first two days of invasive ventilation as ‘hyperoxemic’ or ‘normoxemic’. The co–primary endpoints were prevalence of hyperoxemia (PaO2 > 90 mmHg) and prevalence of excessive oxygen use (FiO2 ≥ 60% while PaO2 > 90 mmHg or SpO2 > 92%). Secondary endpoints included ventilator settings and ventilation parameters, duration of ventilation, length of stay (LOS) in ICU and hospital, and mortality in ICU, hospital, and at day 28 and 90. We used propensity matching to control for observed confounding factors that may influence endpoints. Results: Of 851 COVID–19 patients, 225 (26.4%) were classified as hyperoxemic. Excessive oxygen use occurred in 385 (45.2%) patients. Acute respiratory distress syndrome (ARDS) severity was lowest in hyperoxemic patients. Hyperoxemic patients were ventilated with higher positive end–expiratory pressure (PEEP), while rescue therapies for hypoxemia were applied more often in normoxemic patients. Neither in the unmatched nor in the matched analysis were there differences between hyperoxemic and normoxemic patients with regard to any of the clinical outcomes. Conclusion: In this cohort of invasively ventilated COVID–19 patients, hyperoxemia occurred often and so did excessive oxygen use. The main differences between hyperoxemic and normoxemic patients were ARDS severity and use of PEEP. Clinical outcomes were not different between hyperoxemic and normoxemic patients.