Differences in Ventilation Management and Outcomes between the Two First Waves of the COVID-19 Pandemic—A Comparison between Two Nationwide Observational Studies in The Netherlands
Issued Date
2023-07-01
Resource Type
eISSN
20770383
Scopus ID
2-s2.0-85165198861
Journal Title
Journal of Clinical Medicine
Volume
12
Issue
13
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Clinical Medicine Vol.12 No.13 (2023)
Suggested Citation
Hol L., Schultz M.J., Martin-Loeches I., van Meenen D.M.P., Serpa Neto A., Paulus F. Differences in Ventilation Management and Outcomes between the Two First Waves of the COVID-19 Pandemic—A Comparison between Two Nationwide Observational Studies in The Netherlands. Journal of Clinical Medicine Vol.12 No.13 (2023). doi:10.3390/jcm12134507 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/88116
Title
Differences in Ventilation Management and Outcomes between the Two First Waves of the COVID-19 Pandemic—A Comparison between Two Nationwide Observational Studies in The Netherlands
Author's Affiliation
Mahidol Oxford Tropical Medicine Research Unit
Hogeschool van Amsterdam, University of Applied Sciences
University of Melbourne
Hospital Israelita Albert Einstein
Trinity College Dublin
Nuffield Department of Medicine
Amsterdam UMC - University of Amsterdam
Multidisciplinary Intensive Care Research Organization (MICRO)
Hogeschool van Amsterdam, University of Applied Sciences
University of Melbourne
Hospital Israelita Albert Einstein
Trinity College Dublin
Nuffield Department of Medicine
Amsterdam UMC - University of Amsterdam
Multidisciplinary Intensive Care Research Organization (MICRO)
Other Contributor(s)
Abstract
The aim of this analysis was to compare ventilation management and outcomes in invasively ventilated patients with acute hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19) between the first and second wave in the Netherlands. This is a post hoc analysis of two nationwide observational COVID-19 studies conducted in quick succession. The primary endpoint was ventilation management. Secondary endpoints were tracheostomy use, duration of ventilation, intensive care unit (ICU) and hospital length of stay (LOS), and mortality. We used propensity score matching to control for observed confounding factors. This analysis included 1122 patients from the first and 568 patients from the second wave. Patients in the second wave were sicker, had more comorbidities, and had worse oxygenation parameters. They were ventilated with lower positive end-expiratory pressure and higher fraction inspired oxygen, had a lower oxygen saturation, received neuromuscular blockade more often, and were less often tracheostomized. Duration of ventilation was shorter, but mortality rates were similar. After matching, the fraction of inspired oxygen was lower in the second wave. In patients with acute hypoxemic respiratory failure due to COVID-19, aspects of respiratory care and outcomes rapidly changed over the successive waves.