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 adm...

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Autores: Torres, Antoni, Motos, Anna, Riera, Jordi, Fernández Barat, Laia, Ceccato, Adrián, Pérez Arnal, Raquel, Cantón Bulnes, María Luisa, Barbé, Ferran
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Recursos:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/137787
Acesso em linha:https://hdl.handle.net/11441/137787
https://doi.org/10.1186/s13054-021-03727-x
Access Level:acceso abierto
Palavra-chave:Ventilatory ratio
Mechanical ventilation
COVID-19
SARS-CoV-2
Coronavirus
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oai_identifier_str oai:idus.us.es:11441/137787
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repository_id_str
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, RaquelCantón Bulnes, María LuisaBarbé, FerranVentilatory ratioMechanical ventilationCOVID-19SARS-CoV-2CoronavirusBackground 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.Instituto de Salud Carlos III de Madrid COV20/00110, ISCIIIBMCMedicina2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/137787https://doi.org/10.1186/s13054-021-03727-xreponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésCritical Care, 25 (1), 331.https://ccforum.biomedcentral.com/articles/10.1186/s13054-021-03727-xinfo:eu-repo/semantics/openAccessoai:idus.us.es:11441/1377872026-06-17T12:51:07Z
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
Ventilatory ratio
Mechanical ventilation
COVID-19
SARS-CoV-2
Coronavirus
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
Cantón Bulnes, María Luisa
Barbé, Ferran
author Torres, Antoni
author_facet Torres, Antoni
Motos, Anna
Riera, Jordi
Fernández Barat, Laia
Ceccato, Adrián
Pérez Arnal, Raquel
Cantón Bulnes, María Luisa
Barbé, Ferran
author_role author
author2 Motos, Anna
Riera, Jordi
Fernández Barat, Laia
Ceccato, Adrián
Pérez Arnal, Raquel
Cantón Bulnes, María Luisa
Barbé, Ferran
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Medicina
dc.subject.none.fl_str_mv Ventilatory ratio
Mechanical ventilation
COVID-19
SARS-CoV-2
Coronavirus
topic Ventilatory ratio
Mechanical ventilation
COVID-19
SARS-CoV-2
Coronavirus
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
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/137787
https://doi.org/10.1186/s13054-021-03727-x
url https://hdl.handle.net/11441/137787
https://doi.org/10.1186/s13054-021-03727-x
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Critical Care, 25 (1), 331.
https://ccforum.biomedcentral.com/articles/10.1186/s13054-021-03727-x
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.301629

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