Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort study

Question: We evaluated whether the time between frst respiratory support and intubation of patients receiving invasive mechanical ventilation (IMV) due to COVID-19 was associated with mortality or pulmonary sequelae. Materials and methods: Prospective cohort of critical COVID-19 patients on IMV. Pat...

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Autores: González, Jessica, Benítez, Iván D., Gonzalo-Calvo, David de, Torres, Gerard, Batlle, Jordi de, Gómez, Silvia, Moncusí Moix, Anna, Carmona, Paola, Santisteve, Sally, Monge, Aida, Gort Paniello, Clara, Zuil, María, Cabo Gambín, Ramón, Manzano, Senra, Carlos, Vengoechea Aragoncillo, José Javier, Vaca, Rafaela, Minguez, Olga, Aguilar Cabello, María, Ferrer Roca, Ricard, Ceccato, Adrian, Fernández Barat, Laia, Motos, Ana, Riera, Jordi, Menéndez, Rosario, García Gasulla, Dario, Peñuelas, Oscar, Labarca, Gonzalo, Caballero, Jesús, Barberà, Carme, Torres Martí, Antoni, Barbé, Ferran, CIBERESUCICOVID Project (COV20/00110, ISCIII)
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/186115
Acceso en línea:https://hdl.handle.net/2445/186115
Access Level:acceso abierto
Palabra clave:COVID-19
Síndrome del destret respiratori de l'adult
Malalts en estat crític
Intubació
Malalties del pulmó
Adult respiratory distress syndrome
Critically ill
Intubation
Pulmonary diseases
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spelling Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort studyGonzález, JessicaBenítez, Iván D.Gonzalo-Calvo, David deTorres, GerardBatlle, Jordi deGómez, SilviaMoncusí Moix, AnnaCarmona, PaolaSantisteve, SallyMonge, AidaGort Paniello, ClaraZuil, MaríaCabo Gambín, RamónManzano, Senra, CarlosVengoechea Aragoncillo, José JavierVaca, RafaelaMinguez, OlgaAguilar Cabello, MaríaFerrer Roca, RicardCeccato, AdrianFernández Barat, LaiaMotos, AnaRiera, JordiMenéndez, RosarioGarcía Gasulla, DarioPeñuelas, OscarLabarca, GonzaloCaballero, JesúsBarberà, CarmeTorres Martí, AntoniBarbé, FerranCIBERESUCICOVID Project (COV20/00110, ISCIII)COVID-19Síndrome del destret respiratori de l'adultMalalts en estat críticIntubacióMalalties del pulmóCOVID-19Adult respiratory distress syndromeCritically illIntubationPulmonary diseasesQuestion: We evaluated whether the time between frst respiratory support and intubation of patients receiving invasive mechanical ventilation (IMV) due to COVID-19 was associated with mortality or pulmonary sequelae. Materials and methods: Prospective cohort of critical COVID-19 patients on IMV. Patients were classifed as early intubation if they were intubated within the frst 48 h from the frst respiratory support or delayed intubation if they were intubated later. Surviving patients were evaluated after hospital discharge. Results: We included 205 patients (140 with early IMV and 65 with delayed IMV). The median [p25;p75] age was 63 [56.0; 70.0] years, and 74.1% were male. The survival analysis showed a signifcant increase in the risk of mortality in the delayed group with an adjusted hazard ratio (HR) of 2.45 (95% CI 1.29-4.65). The continuous predictor time to IMV showed a nonlinear association with the risk of in-hospital mortality. A multivariate mortality model showed that delay of IMV was a factor associated with mortality (HR of 2.40; 95% CI 1.42-4.1). During follow-up, patients in the delayed group showed a worse DLCO (mean diference of −10.77 (95% CI −18.40 to −3.15), with a greater number of afected lobes (+1.51 [95% CI 0.89-2.13]) and a greater TSS (+4.35 [95% CI 2.41-6.27]) in the chest CT scan. Conclusions: Among critically ill patients with COVID-19 who required IMV, the delay in intubation from the frst respiratory support was associated with an increase in hospital mortality and worse pulmonary sequelae during follow-up. Keywords: COVID-19, ARDS, Critically ill patients, Early intubation, Respiratory management, Pulmonary sequelaeBioMed Central2022202220222022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion11 p.application/pdfhttps://hdl.handle.net/2445/186115Articles publicats en revistes (Medicina)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1186/s13054-021-03882-1Critical Care, 2022, vol. 26, num. 1, p. 18-28https://doi.org/10.1186/s13054-021-03882-1cc-by (c) González, Jessica et al., 2022https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1861152026-05-29T05:05:01Z
dc.title.none.fl_str_mv Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort study
title Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort study
spellingShingle Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort study
González, Jessica
COVID-19
Síndrome del destret respiratori de l'adult
Malalts en estat crític
Intubació
Malalties del pulmó
COVID-19
Adult respiratory distress syndrome
Critically ill
Intubation
Pulmonary diseases
title_short Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort study
title_full Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort study
title_fullStr Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort study
title_full_unstemmed Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort study
title_sort Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort study
dc.creator.none.fl_str_mv González, Jessica
Benítez, Iván D.
Gonzalo-Calvo, David de
Torres, Gerard
Batlle, Jordi de
Gómez, Silvia
Moncusí Moix, Anna
Carmona, Paola
Santisteve, Sally
Monge, Aida
Gort Paniello, Clara
Zuil, María
Cabo Gambín, Ramón
Manzano, Senra, Carlos
Vengoechea Aragoncillo, José Javier
Vaca, Rafaela
Minguez, Olga
Aguilar Cabello, María
Ferrer Roca, Ricard
Ceccato, Adrian
Fernández Barat, Laia
Motos, Ana
Riera, Jordi
Menéndez, Rosario
García Gasulla, Dario
Peñuelas, Oscar
Labarca, Gonzalo
Caballero, Jesús
Barberà, Carme
Torres Martí, Antoni
Barbé, Ferran
CIBERESUCICOVID Project (COV20/00110, ISCIII)
author González, Jessica
author_facet González, Jessica
Benítez, Iván D.
Gonzalo-Calvo, David de
Torres, Gerard
Batlle, Jordi de
Gómez, Silvia
Moncusí Moix, Anna
Carmona, Paola
Santisteve, Sally
Monge, Aida
Gort Paniello, Clara
Zuil, María
Cabo Gambín, Ramón
Manzano, Senra, Carlos
Vengoechea Aragoncillo, José Javier
Vaca, Rafaela
Minguez, Olga
Aguilar Cabello, María
Ferrer Roca, Ricard
Ceccato, Adrian
Fernández Barat, Laia
Motos, Ana
Riera, Jordi
Menéndez, Rosario
García Gasulla, Dario
Peñuelas, Oscar
Labarca, Gonzalo
Caballero, Jesús
Barberà, Carme
Torres Martí, Antoni
Barbé, Ferran
CIBERESUCICOVID Project (COV20/00110, ISCIII)
author_role author
author2 Benítez, Iván D.
Gonzalo-Calvo, David de
Torres, Gerard
Batlle, Jordi de
Gómez, Silvia
Moncusí Moix, Anna
Carmona, Paola
Santisteve, Sally
Monge, Aida
Gort Paniello, Clara
Zuil, María
Cabo Gambín, Ramón
Manzano, Senra, Carlos
Vengoechea Aragoncillo, José Javier
Vaca, Rafaela
Minguez, Olga
Aguilar Cabello, María
Ferrer Roca, Ricard
Ceccato, Adrian
Fernández Barat, Laia
Motos, Ana
Riera, Jordi
Menéndez, Rosario
García Gasulla, Dario
Peñuelas, Oscar
Labarca, Gonzalo
Caballero, Jesús
Barberà, Carme
Torres Martí, Antoni
Barbé, Ferran
CIBERESUCICOVID Project (COV20/00110, ISCIII)
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
Síndrome del destret respiratori de l'adult
Malalts en estat crític
Intubació
Malalties del pulmó
COVID-19
Adult respiratory distress syndrome
Critically ill
Intubation
Pulmonary diseases
topic COVID-19
Síndrome del destret respiratori de l'adult
Malalts en estat crític
Intubació
Malalties del pulmó
COVID-19
Adult respiratory distress syndrome
Critically ill
Intubation
Pulmonary diseases
description Question: We evaluated whether the time between frst respiratory support and intubation of patients receiving invasive mechanical ventilation (IMV) due to COVID-19 was associated with mortality or pulmonary sequelae. Materials and methods: Prospective cohort of critical COVID-19 patients on IMV. Patients were classifed as early intubation if they were intubated within the frst 48 h from the frst respiratory support or delayed intubation if they were intubated later. Surviving patients were evaluated after hospital discharge. Results: We included 205 patients (140 with early IMV and 65 with delayed IMV). The median [p25;p75] age was 63 [56.0; 70.0] years, and 74.1% were male. The survival analysis showed a signifcant increase in the risk of mortality in the delayed group with an adjusted hazard ratio (HR) of 2.45 (95% CI 1.29-4.65). The continuous predictor time to IMV showed a nonlinear association with the risk of in-hospital mortality. A multivariate mortality model showed that delay of IMV was a factor associated with mortality (HR of 2.40; 95% CI 1.42-4.1). During follow-up, patients in the delayed group showed a worse DLCO (mean diference of −10.77 (95% CI −18.40 to −3.15), with a greater number of afected lobes (+1.51 [95% CI 0.89-2.13]) and a greater TSS (+4.35 [95% CI 2.41-6.27]) in the chest CT scan. Conclusions: Among critically ill patients with COVID-19 who required IMV, the delay in intubation from the frst respiratory support was associated with an increase in hospital mortality and worse pulmonary sequelae during follow-up. Keywords: COVID-19, ARDS, Critically ill patients, Early intubation, Respiratory management, Pulmonary sequelae
publishDate 2022
dc.date.none.fl_str_mv 2022
2022
2022
2022
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/2445/186115
url https://hdl.handle.net/2445/186115
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1186/s13054-021-03882-1
Critical Care, 2022, vol. 26, num. 1, p. 18-28
https://doi.org/10.1186/s13054-021-03882-1
dc.rights.none.fl_str_mv cc-by (c) González, Jessica et al., 2022
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) González, Jessica et al., 2022
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 11 p.
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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