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 first 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. Pa...

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Autores: González, Jessica, Benítez, Iván, de Gonzalo Calvo, David, Torres, Gerard, Batlle Garcia, Jordi de, Gómez Falguera, Silvia, Moncusí Moix, Anna, Carmona, Paola, Santisteve, Sally, Monge Esqué, Aida, Gort Paniello, Clara, Zuil, María, Cabo Gambín, Ramón, Manzano Senra, Carlos, Vengoechea Aragoncillo, José Javier, Vaca, Rafaela, Minguez Roure, Olga, Aguilar, María, Ferrer, Ricard, Ceccato, Adrián, Fernández Barat, Laia, Motos, Anna, Riera, Jordi, Menéndez, Rosario, García Gasulla, Darío, Peñuelas, Oscar, Labarca, Gonzalo, Caballero, Jesús, Barberà, Carme, Torres, Antoni, Barbé Illa, Ferran
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:10459.1/73137
Acceso en línea:https://doi.org/10.1186/s13054-021-03882-1
http://hdl.handle.net/10459.1/73137
Access Level:acceso abierto
Palabra clave:ARDS
COVID-19
Critically ill patients
Early intubation
Pulmonary sequelae
Respiratory management
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network_acronym_str ES
network_name_str España
repository_id_str
spelling Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort studyGonzález, JessicaBenítez, Ivánde Gonzalo Calvo, DavidTorres, GerardBatlle Garcia, Jordi deGómez Falguera, SilviaMoncusí Moix, AnnaCarmona, PaolaSantisteve, SallyMonge Esqué, AidaGort Paniello, ClaraZuil, MaríaCabo Gambín, RamónManzano Senra, CarlosVengoechea Aragoncillo, José JavierVaca, RafaelaMinguez Roure, OlgaAguilar, MaríaFerrer, RicardCeccato, AdriánFernández Barat, LaiaMotos, AnnaRiera, JordiMenéndez, RosarioGarcía Gasulla, DaríoPeñuelas, OscarLabarca, GonzaloCaballero, JesúsBarberà, CarmeTorres, AntoniBarbé Illa, FerranARDSCOVID-19Critically ill patientsEarly intubationPulmonary sequelaeRespiratory managementQuestion: We evaluated whether the time between first 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 classified as early intubation if they were intubated within the first 48 h from the first 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 significant 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 difference of - 10.77 (95% CI - 18.40 to - 3.15), with a greater number of affected 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 first respiratory support was associated with an increase in hospital mortality and worse pulmonary sequelae during follow-up.The study was supported in part by ISCIII (CIBERESUCICOVID, COV20/00110), co‑funded by ERDF, “Una manera de hacer Europa” and Donation pro‑gram "estar preparados". UNESPA. Madrid. Spain David de Gonzalo Calvo acknowledges receiving financial support from Instituto de Salud Carlos III (ISCIII); Miguel Servet 2020: CP20/00041), co‑funded by the European Social Fund (ESF), “Investing in your future”. JdB acknowledges receiving financial support from Instituto de Salud Carlos III (Miguel Servet 2019: CP19/00108), co‑funded by European Regional European Social Fund (ESF), “Investing in your future"BCM202220222022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://doi.org/10.1186/s13054-021-03882-1http://hdl.handle.net/10459.1/73137http://hdl.handle.net/10459.1/73137reponame: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. 16, núm. 1cc-by (c)Authors, 2022info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by/4.0/oai:recercat.cat:10459.1/731372026-05-29T05:05:01Z
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
ARDS
COVID-19
Critically ill patients
Early intubation
Pulmonary sequelae
Respiratory management
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
de Gonzalo Calvo, David
Torres, Gerard
Batlle Garcia, Jordi de
Gómez Falguera, Silvia
Moncusí Moix, Anna
Carmona, Paola
Santisteve, Sally
Monge Esqué, Aida
Gort Paniello, Clara
Zuil, María
Cabo Gambín, Ramón
Manzano Senra, Carlos
Vengoechea Aragoncillo, José Javier
Vaca, Rafaela
Minguez Roure, Olga
Aguilar, María
Ferrer, Ricard
Ceccato, Adrián
Fernández Barat, Laia
Motos, Anna
Riera, Jordi
Menéndez, Rosario
García Gasulla, Darío
Peñuelas, Oscar
Labarca, Gonzalo
Caballero, Jesús
Barberà, Carme
Torres, Antoni
Barbé Illa, Ferran
author González, Jessica
author_facet González, Jessica
Benítez, Iván
de Gonzalo Calvo, David
Torres, Gerard
Batlle Garcia, Jordi de
Gómez Falguera, Silvia
Moncusí Moix, Anna
Carmona, Paola
Santisteve, Sally
Monge Esqué, Aida
Gort Paniello, Clara
Zuil, María
Cabo Gambín, Ramón
Manzano Senra, Carlos
Vengoechea Aragoncillo, José Javier
Vaca, Rafaela
Minguez Roure, Olga
Aguilar, María
Ferrer, Ricard
Ceccato, Adrián
Fernández Barat, Laia
Motos, Anna
Riera, Jordi
Menéndez, Rosario
García Gasulla, Darío
Peñuelas, Oscar
Labarca, Gonzalo
Caballero, Jesús
Barberà, Carme
Torres, Antoni
Barbé Illa, Ferran
author_role author
author2 Benítez, Iván
de Gonzalo Calvo, David
Torres, Gerard
Batlle Garcia, Jordi de
Gómez Falguera, Silvia
Moncusí Moix, Anna
Carmona, Paola
Santisteve, Sally
Monge Esqué, Aida
Gort Paniello, Clara
Zuil, María
Cabo Gambín, Ramón
Manzano Senra, Carlos
Vengoechea Aragoncillo, José Javier
Vaca, Rafaela
Minguez Roure, Olga
Aguilar, María
Ferrer, Ricard
Ceccato, Adrián
Fernández Barat, Laia
Motos, Anna
Riera, Jordi
Menéndez, Rosario
García Gasulla, Darío
Peñuelas, Oscar
Labarca, Gonzalo
Caballero, Jesús
Barberà, Carme
Torres, Antoni
Barbé Illa, Ferran
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
dc.subject.none.fl_str_mv ARDS
COVID-19
Critically ill patients
Early intubation
Pulmonary sequelae
Respiratory management
topic ARDS
COVID-19
Critically ill patients
Early intubation
Pulmonary sequelae
Respiratory management
description Question: We evaluated whether the time between first 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 classified as early intubation if they were intubated within the first 48 h from the first 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 significant 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 difference of - 10.77 (95% CI - 18.40 to - 3.15), with a greater number of affected 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 first respiratory support was associated with an increase in hospital mortality and worse pulmonary sequelae during follow-up.
publishDate 2022
dc.date.none.fl_str_mv 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://doi.org/10.1186/s13054-021-03882-1
http://hdl.handle.net/10459.1/73137
http://hdl.handle.net/10459.1/73137
url https://doi.org/10.1186/s13054-021-03882-1
http://hdl.handle.net/10459.1/73137
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. 16, núm. 1
dc.rights.none.fl_str_mv cc-by (c)Authors, 2022
info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by/4.0/
rights_invalid_str_mv cc-by (c)Authors, 2022
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BCM
publisher.none.fl_str_mv BCM
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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score 15.812429

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