The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU ad...

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Autores: Torres, Antoni, Motos, Anna, Riera, Jordi, Fernández Barat, Laia, Ceccato, Adrián, Pérez Arnal, Raquel, García Gasulla, Darío, Peñuelas, Óscar, Lorente Balanza, José Ángel, Barbé, Ferran, Et al.
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad Europea (UEM)
Repositorio:ABACUS. Repositorio de Producción Científica
Idioma:inglés
OAI Identifier:oai:abacus.universidadeuropea.com:11268/11527
Acceso en línea:http://hdl.handle.net/11268/11527
Access Level:acceso abierto
Palabra clave:Enfermedades pulmonares
Infecciones por coronavirus
Enfermedad transmisible
Aparato respiratorio
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spelling The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patientsTorres, AntoniMotos, AnnaRiera, JordiFernández Barat, LaiaCeccato, AdriánPérez Arnal, RaquelGarcía Gasulla, DaríoPeñuelas, ÓscarLorente Balanza, José ÁngelBarbé, FerranEt al.Enfermedades pulmonaresInfecciones por coronavirusEnfermedad transmisibleAparato respiratorioBackground: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation.20222022-07-2420212021-01-0120212021-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articlehttp://hdl.handle.net/11268/11527reponame:ABACUS. Repositorio de Producción Científicainstname:Universidad Europea (UEM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:abacus.universidadeuropea.com:11268/115272026-06-11T12:41:27Z
dc.title.none.fl_str_mv The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
title The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
spellingShingle The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
Torres, Antoni
Enfermedades pulmonares
Infecciones por coronavirus
Enfermedad transmisible
Aparato respiratorio
title_short The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
title_full The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
title_fullStr The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
title_full_unstemmed The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
title_sort The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
dc.creator.none.fl_str_mv Torres, Antoni
Motos, Anna
Riera, Jordi
Fernández Barat, Laia
Ceccato, Adrián
Pérez Arnal, Raquel
García Gasulla, Darío
Peñuelas, Óscar
Lorente Balanza, José Ángel
Barbé, Ferran
Et al.
author Torres, Antoni
author_facet Torres, Antoni
Motos, Anna
Riera, Jordi
Fernández Barat, Laia
Ceccato, Adrián
Pérez Arnal, Raquel
García Gasulla, Darío
Peñuelas, Óscar
Lorente Balanza, José Ángel
Barbé, Ferran
Et al.
author_role author
author2 Motos, Anna
Riera, Jordi
Fernández Barat, Laia
Ceccato, Adrián
Pérez Arnal, Raquel
García Gasulla, Darío
Peñuelas, Óscar
Lorente Balanza, José Ángel
Barbé, Ferran
Et al.
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Enfermedades pulmonares
Infecciones por coronavirus
Enfermedad transmisible
Aparato respiratorio
topic Enfermedades pulmonares
Infecciones por coronavirus
Enfermedad transmisible
Aparato respiratorio
description Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021-01-01
2021
2021-01-01
2022
2022-07-24
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/11268/11527
url http://hdl.handle.net/11268/11527
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:ABACUS. Repositorio de Producción Científica
instname:Universidad Europea (UEM)
instname_str Universidad Europea (UEM)
reponame_str ABACUS. Repositorio de Producción Científica
collection ABACUS. Repositorio de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.301603

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