Dead space estimates may not be independently associated with 28-day mortality in COVID-19 ARDS
Autor: | Morales-Quinteros, Luis, Neto, Ary Serpa, Artigas, Antonio, Blanch, Lluis, Botta, Michela, Kaufman, David A, Schultz, Marcus J, Tsonas, Anissa M, Paulus, Frederique, Bos, Lieuwe D, Study group members AMC, de Klerk, Eline S., Breel, Jennifer |
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Přispěvatelé: | Critical Care, Pulmonary medicine, Public and occupational health, Intensive care medicine, ACS - Pulmonary hypertension & thrombosis, ACS - Heart failure & arrhythmias, ACS - Diabetes & metabolism, RS: NUTRIM - R2 - Liver and digestive health, MUMC+: MA Arts Assistenten IC (9), Intensive Care, MUMC+: MA Medische Staf IC (9), Group, PRoVENT-COVID Study, Intensive Care Medicine, Graduate School, AII - Inflammatory diseases, Nursing, Anesthesiology, ACS - Microcirculation, Faculteit Gezondheid, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE) |
Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
ARDS
ademhalingsfunctietesten intensive care units medicine.medical_treatment Dead space Prognostication 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine VOLUMETRIC CAPNOGRAPHY FRACTION Respiratory Distress Syndrome/etiology intensive care afdelingen 0302 clinical medicine patient acuity adults vrouwen Respiratory dead space zorgbehoefte Acute respiratory distress syndrome mannen Respiration respiratory function tests volwassenen Medical emergencies. Critical care. Intensive care. First aid dode ruimte respiratory distress syndrome PROGNOSTIC VALUE female prognose Artificial Breathing COVID-19/complications Adult medicine.medical_specialty respiratory mechanics etiology Respiratory Dead Space pCO2 ACUTE LUNG INJURY 03 medical and health sciences male Intensive care medicine Humans artificial respiration Mortality Retrospective Studies Mechanical ventilation RC86-88.9 business.industry Research biomarkers COVID-19 Ventilatory ratio Retrospective cohort study medicine.disease Respiration Artificial roc curve 030228 respiratory system Emergency medicine kunstmatige ademhaling prognosis ademhalingstechnieken etiologie business patienten |
Zdroj: | Critical Care, 25(1):171. Springer Science + Business Media Critical Care, 25(1):171. BioMed Central Ltd Critical Care, Vol 25, Iss 1, Pp 1-13 (2021) Critical care (London, England), 25(1):171. Springer Science + Business Media Critical Care on behalf of the PRoVENT-COVID Study Group 2021, ' Dead space estimates may not be independently associated with 28-day mortality in COVID-19 ARDS ', Critical Care, vol. 25, no. 1, 171 . https://doi.org/10.1186/s13054-021-03570-0 Critical Care, 25:171. BioMed Central Critical care (London, England), 25(1):171. BMC |
ISSN: | 1364-8535 1466-609X |
DOI: | 10.1186/s13054-021-03570-0 |
Popis: | Background Estimates for dead space ventilation have been shown to be independently associated with an increased risk of mortality in the acute respiratory distress syndrome and small case series of COVID-19-related ARDS. Methods Secondary analysis from the PRoVENT-COVID study. The PRoVENT-COVID is a national, multicenter, retrospective observational study done at 22 intensive care units in the Netherlands. Consecutive patients aged at least 18 years were eligible for participation if they had received invasive ventilation for COVID-19 at a participating ICU during the first month of the national outbreak in the Netherlands. The aim was to quantify the dynamics and determine the prognostic value of surrogate markers of wasted ventilation in patients with COVID-19-related ARDS. Results A total of 927 consecutive patients admitted with COVID-19-related ARDS were included in this study. Estimations of wasted ventilation such as the estimated dead space fraction (by Harris–Benedict and direct method) and ventilatory ratio were significantly higher in non-survivors than survivors at baseline and during the following days of mechanical ventilation (p 2 ratio was lower in non-survivors than in survivors (p 2 ratio. After adjustment for a base risk model that included chronic comorbidities and ventilation- and oxygenation-parameters, none of the dead space estimates measured at the start of ventilation or the following days were significantly associated with 28-day mortality. Conclusions There is significant impairment of ventilation in the early course of COVID-19-related ARDS but quantification of this impairment does not add prognostic information when added to a baseline risk model. Trial registration: ISRCTN04346342. Registered 15 April 2020. Retrospectively registered. |
Databáze: | OpenAIRE |
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