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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Detalles Bibliográficos
Autores: Torres Martí, Antoni, Marin Corral, Judith, Barbé, Ferran, CIBERESUCICOVID Project (COV20/00110, ISCIII)
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
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:10230/53318
Acceso en línea:http://hdl.handle.net/10230/53318
http://dx.doi.org/10.1186/s13054-021-03727-x
Access Level:acceso abierto
Palabra clave:COVID-19
Coronavirus
Mechanical ventilation
SARS-CoV-2
Ventilatory ratio
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spelling The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patientsTorres Martí, AntoniMarin Corral, JudithBarbé, FerranCIBERESUCICOVID Project (COV20/00110, ISCIII)COVID-19CoronavirusMechanical ventilationSARS-CoV-2Ventilatory ratioBackground: 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.BioMed Central202220222021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/53318http://dx.doi.org/10.1186/s13054-021-03727-xreponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésCopyright © The Author(s) 2021. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/533182026-05-29T05:05:01Z
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 Martí, Antoni
COVID-19
Coronavirus
Mechanical ventilation
SARS-CoV-2
Ventilatory ratio
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 Martí, Antoni
Marin Corral, Judith
Barbé, Ferran
CIBERESUCICOVID Project (COV20/00110, ISCIII)
author Torres Martí, Antoni
author_facet Torres Martí, Antoni
Marin Corral, Judith
Barbé, Ferran
CIBERESUCICOVID Project (COV20/00110, ISCIII)
author_role author
author2 Marin Corral, Judith
Barbé, Ferran
CIBERESUCICOVID Project (COV20/00110, ISCIII)
author2_role author
author
author
dc.subject.none.fl_str_mv COVID-19
Coronavirus
Mechanical ventilation
SARS-CoV-2
Ventilatory ratio
topic COVID-19
Coronavirus
Mechanical ventilation
SARS-CoV-2
Ventilatory ratio
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
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 http://hdl.handle.net/10230/53318
http://dx.doi.org/10.1186/s13054-021-03727-x
url http://hdl.handle.net/10230/53318
http://dx.doi.org/10.1186/s13054-021-03727-x
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv 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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