Low tidal volume ventilation is associated with mortality in COVID-19 patients-Insights from the PRoVENT-COVID study.
COVID-19
Coronavirus disease 2019
Mortality
Tidal volume
Journal
Journal of critical care
ISSN: 1557-8615
Titre abrégé: J Crit Care
Pays: United States
ID NLM: 8610642
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
received:
08
11
2021
revised:
28
03
2022
accepted:
17
04
2022
pubmed:
2
5
2022
medline:
9
6
2022
entrez:
1
5
2022
Statut:
ppublish
Résumé
Low tidal volume ventilation (LTVV) is associated with mortality in patients with acute respiratory distress syndrome. We investigated the association of LTVV with mortality in COVID-19 patients. Secondary analysis of a national observational study in COVID-19 patients in the first wave of the pandemic. We compared COVID-19 patients that received LTVV, defined as controlled ventilation with a median tidal volume ≤ 6 mL/kg predicted body weight over the first 4 calendar days of ventilation, with patients that did not receive LTVV. The primary endpoint was 28-day mortality. In addition, we identified factors associated with use of LTVV. Of 903 patients, 294 (32.5%) received LTVV. Disease severity scores and ARDS classification was not different between the two patient groups. The primary endpoint, 28-day mortality, was met in 68 out of 294 patients (23.1%) that received LTVV versus in 193 out of 609 patients (31.7%) that did not receive LTVV (P < 0.001). LTVV was independently associated with 28-day mortality (HR, 0.68 (0.45 to 0.95); P = 0.025). Age, height, the initial tidal volume and continuous muscle paralysis was independently associated with use of LTVV. In this cohort of invasively ventilated COVID-19 patients, approximately a third of patients received LTVV. Use of LTVV was independently associated with reduced 28-day mortality. The initial tidal volume and continuous muscle paralysis were potentially modifiable factors associated with use of LTVV. These findings are important as they could help clinicians to recognize patients who are at risk of not receiving LTVV.
Identifiants
pubmed: 35490503
pii: S0883-9441(22)00076-4
doi: 10.1016/j.jcrc.2022.154047
pmc: PMC9047696
pii:
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
154047Informations de copyright
Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Ary Serpa Neto reports personal fees from Dräger, outside of the submitted work. Marcus Schultz reports personal fees from Hamilton and Xenios/Novalung, outside of the submitted work. Sunny Nijbroek, Liselotte Hol, Dimitri Ivanov, and Frederique Paulus declare no competing interests.
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