Clinical characteristics, physiological features, and outcomes associated with hypercapnia in patients with acute hypoxemic respiratory failure due to COVID–19—-insights from the PRoVENT–COVID study
Issued Date
2022-06-01
Resource Type
ISSN
08839441
eISSN
15578615
Scopus ID
2-s2.0-85126975847
Pubmed ID
35339900
Journal Title
Journal of Critical Care
Volume
69
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Critical Care Vol.69 (2022)
Suggested Citation
Tsonas A.M., Botta M., Horn J., Morales-Quinteros L., Artigas A., Schultz M.J., Paulus F., Neto A.S. Clinical characteristics, physiological features, and outcomes associated with hypercapnia in patients with acute hypoxemic respiratory failure due to COVID–19—-insights from the PRoVENT–COVID study. Journal of Critical Care Vol.69 (2022). doi:10.1016/j.jcrc.2022.154022 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85843
Title
Clinical characteristics, physiological features, and outcomes associated with hypercapnia in patients with acute hypoxemic respiratory failure due to COVID–19—-insights from the PRoVENT–COVID study
Author's Affiliation
Amsterdam Neuroscience
Institut d’Investigació i Innovació Parc Taulí (I3PT)
Melbourne Medical School
Hogeschool van Amsterdam, University of Applied Sciences
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Universitat Autònoma de Barcelona
Monash University
Hospital Israelita Albert Einstein
Mahidol University
Hospital Universitari de Bellvitge
Nuffield Department of Medicine
Austin Hospital
Amsterdam UMC
General University Hospital of Catalonia
Hospital Parc Taulí
Institut d’Investigació i Innovació Parc Taulí (I3PT)
Melbourne Medical School
Hogeschool van Amsterdam, University of Applied Sciences
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Universitat Autònoma de Barcelona
Monash University
Hospital Israelita Albert Einstein
Mahidol University
Hospital Universitari de Bellvitge
Nuffield Department of Medicine
Austin Hospital
Amsterdam UMC
General University Hospital of Catalonia
Hospital Parc Taulí
Other Contributor(s)
Abstract
Purpose: We determined the incidence of hypercapnia and associations with outcome in invasively ventilated COVID–19 patients. Methods: Posthoc analysis of a national, multicenter, observational study in 22 ICUs. Patients were classified as ‘hypercapnic’ or ‘normocapnic’ in the first three days of invasive ventilation. Primary endpoint was prevalence of hypercapnia. Secondary endpoints were ventilator parameters, length of stay (LOS) in ICU and hospital, and mortality in ICU, hospital, at day 28 and 90. Results: Of 824 patients, 485 (58.9%) were hypercapnic. Hypercapnic patients had a higher BMI and had COPD, severe ARDS and venous thromboembolic events more often. Hypercapnic patients were ventilated with lower tidal volumes, higher respiratory rates, higher driving pressures, and with more mechanical power of ventilation. Hypercapnic patients had comparable minute volumes but higher ventilatory ratios than normocapnic patients. In hypercapnic patients, ventilation and LOS in ICU and hospital was longer, but mortality was comparable to normocapnic patients. Conclusion: Hypercapnia occurs often in invasively ventilated COVID–19 patients. Main differences between hypercapnic and normocapnic patients are severity of ARDS, occurrence of venous thromboembolic events, and a higher ventilation ratio. Hypercapnia has an association with duration of ventilation and LOS in ICU and hospital, but not with mortality.