Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID era
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 a...
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2024-08-01
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| Online Access: | https://doi.org/10.1186/s12931-024-02910-2 |
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| author | Fleur–Stefanie L. I. M. van der Ven Siebe G. Blok Luciano C. Azevedo Giacomo Bellani Michela Botta Elisa Estenssoro Eddy Fan Juliana Carvalho Ferreira John G. Laffey Ignacio Martin–Loeches Ana Motos Tai Pham Oscar Peñuelas Antonio Pesenti Luigi Pisani Ary Serpa Neto Marcus J. Schultz Antoni Torres Anissa M. Tsonas Frederique Paulus David M. P. van Meenen and for the ERICC– LUNG SAFE– PRoVENT–COVID– EPICCoV– CIBERESUCICOVID– SATI–COVID–19–investigators |
| author_facet | Fleur–Stefanie L. I. M. van der Ven Siebe G. Blok Luciano C. Azevedo Giacomo Bellani Michela Botta Elisa Estenssoro Eddy Fan Juliana Carvalho Ferreira John G. Laffey Ignacio Martin–Loeches Ana Motos Tai Pham Oscar Peñuelas Antonio Pesenti Luigi Pisani Ary Serpa Neto Marcus J. Schultz Antoni Torres Anissa M. Tsonas Frederique Paulus David M. P. van Meenen and for the ERICC– LUNG SAFE– PRoVENT–COVID– EPICCoV– CIBERESUCICOVID– SATI–COVID–19–investigators |
| author_sort | Fleur–Stefanie L. I. M. van der Ven |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-393babae22f24813acbbc88c19c9a151 |
| institution | DOAJ |
| issn | 1465-993X |
| language | English |
| publishDate | 2024-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj-art-393babae22f24813acbbc88c19c9a1512025-08-20T02:49:25ZengBMCRespiratory Research1465-993X2024-08-0125111110.1186/s12931-024-02910-2Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID eraFleur–Stefanie L. I. M. van der Ven0Siebe G. Blok1Luciano C. Azevedo2Giacomo Bellani3Michela Botta4Elisa Estenssoro5Eddy Fan6Juliana Carvalho Ferreira7John G. Laffey8Ignacio Martin–Loeches9Ana Motos10Tai Pham11Oscar Peñuelas12Antonio Pesenti13Luigi Pisani14Ary Serpa Neto15Marcus J. Schultz16Antoni Torres17Anissa M. Tsonas18Frederique Paulus19David M. P. van Meenen20and for the ERICC–LUNG SAFE–PRoVENT–COVID–EPICCoV–CIBERESUCICOVID–SATI–COVID–19–investigatorsDepartment of Intensive Care, Amsterdam University Medical Centers, Location ‘AMC’Department of Intensive Care, Amsterdam University Medical Centers, Location ‘AMC’Department of Emergency Medicine, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São PauloCentre for Medical Sciences (CISMed), University of TrentoDepartment of Intensive Care, Amsterdam University Medical Centers, Location ‘AMC’Department of Intensive Care, Hospital Interzonal de Agudos General San Martin La PlataInterdepartmental Division of Critical Care Medicine, University of TorontoDepartment of Pulmonology, Instituto Do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao PauloDepartment of Anaesthesiology and Intensive Care, Galway University Hospital, Saolta Hospital GroupDepartment of Intensive Care, Multidisciplinary Intensive Care Research Organization (MICRO), St James’ HospitalDepartement of Pulmonology, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Hospital Clínic de BarcelonaEquipe d’Epidémiologie Respiratoire Integrative, Université Paris–SaclayCentro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Institute of Health Carlos IIIFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoDepartment of Intensive Care, Amsterdam University Medical Centers, Location ‘AMC’Department of Intensive Care, Hospital Israelita Albert EinsteinDepartment of Intensive Care, Amsterdam University Medical Centers, Location ‘AMC’Departement of Pulmonology, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Hospital Clínic de BarcelonaDepartment of Intensive Care, Amsterdam University Medical Centers, Location ‘AMC’Department of Intensive Care, Amsterdam University Medical Centers, Location ‘AMC’Department of Intensive Care, Amsterdam University Medical Centers, Location ‘AMC’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.https://doi.org/10.1186/s12931-024-02910-2Acute respiratory distress syndromeARDSCOVID–19Critical careMechanical ventilationVentilation management |
| spellingShingle | Fleur–Stefanie L. I. M. van der Ven Siebe G. Blok Luciano C. Azevedo Giacomo Bellani Michela Botta Elisa Estenssoro Eddy Fan Juliana Carvalho Ferreira John G. Laffey Ignacio Martin–Loeches Ana Motos Tai Pham Oscar Peñuelas Antonio Pesenti Luigi Pisani Ary Serpa Neto Marcus J. Schultz Antoni Torres Anissa M. Tsonas Frederique Paulus David M. P. van Meenen and for the ERICC– LUNG SAFE– PRoVENT–COVID– EPICCoV– CIBERESUCICOVID– SATI–COVID–19–investigators Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID era Respiratory Research Acute respiratory distress syndrome ARDS COVID–19 Critical care Mechanical ventilation Ventilation management |
| title | Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID era |
| title_full | Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID era |
| title_fullStr | Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID era |
| title_full_unstemmed | Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID era |
| title_short | Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID era |
| title_sort | epidemiology ventilation management and outcomes of covid 19 ards patients versus patients with ards due to pneumonia in the pre covid era |
| topic | Acute respiratory distress syndrome ARDS COVID–19 Critical care Mechanical ventilation Ventilation management |
| url | https://doi.org/10.1186/s12931-024-02910-2 |
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