Post intensive care syndrome in survivors of COVID-19 who required mechanical ventilation during the third wave of the pandemic: A prospective study.

Autor: Martínez E; Hospital Juan A Fernández, Buenos Aires, Argentina; Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina. Electronic address: eze72martinez@yahoo.com.ar., Aguilera C; Hospital Juan A Fernández, Buenos Aires, Argentina., Márquez D; Hospital Juan A Fernández, Buenos Aires, Argentina., Ziegler G; Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina., Plumet J; Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina., Tschopp L; Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina., Cominotti C; Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina., Sturzenegger V; Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina., Cimino C; Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina., Escobar H; Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina., Pereyra C; Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina., Hidalgo E; Hospital Juan A Fernández, Buenos Aires, Argentina., Adanza SP; Hospital Juan A Fernández, Buenos Aires, Argentina., Morelli DM; Institute for Clinical Effectiveness and Health Politicy (IECS), Buenos Aires, Argentina., Masevicius FD; Sanatorio Otamendi, Buenos Aires, Argentina.
Jazyk: angličtina
Zdroj: Heart & lung : the journal of critical care [Heart Lung] 2023 Nov-Dec; Vol. 62, pp. 72-80. Date of Electronic Publication: 2023 Jun 19.
DOI: 10.1016/j.hrtlng.2023.06.021
Abstrakt: Background: Post intensive care syndrome is defined as the presence of any impairment affecting the physical, psychiatric, or cognitive domains as a result of critical illnesses.
Objectives: To explore functional, cognitive and psychological outcomes at 30 days post hospital discharge among survivors of COVID-19-associated acute respiratory distress syndrome, who required mechanical ventilation.
Methods: Prospective cohort study. We included adult patients with COVID-19-associated acute respiratory distress syndrome, invasively ventilated in two ICUs in Buenos Aires. We measured functional, cognitive and psychological impairments with Barthel index, Montreal Cognitive Assessment test, Patient Health Questionnaire-9 and General Anxiety Disorder-7. Primary outcome was post-intensive care syndrome. Secondary outcome was mortality at 60 days.
Results: We admitted 40 patients, median age was 69 (60-75) and mostly male (75%). Mortality at 60 days was 37%. Cox regression analysis identified diabetes and Apache II as independent predictors of mortality. Out of 22 patients studied, 14 (64%) developed PICS after discharge. With a physical, cognitive and psychological impairment in 64%, 41% and 32% of patients, respectively. Obesity, days of mechanical ventilation, Apache II, vasopressors use, delirium duration and cumulative midazolam dose were associated with functional dependence.
Conclusions: We identified a high prevalence of functional, cognitive and mental impairment at 30 days after hospital discharge in COVID-19-associated acute respiratory distress syndrome survivors, invasively ventilated. The physical domain was the most frequently affected. These findings suggest the need for long-term follow-up of this population.
Competing Interests: Declaration of Competing Interest All authors have disclosed that they do not have any conflicts of interest related to this study.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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