Epidemiology, ventilation management and outcomes of COVID-19 ARDS patients versus patients with ARDS due to pneumonia in the Pre-COVID era

被引：7

作者：

van der Ven, Fleur-Stefanie L. I. M. ^{[1
,2
]}

Blok, Siebe G. ^{[1
]}

Azevedo, Luciano C. ^{[3
,4
]}

Bellani, Giacomo ^{[5
,6
]}

Botta, Michela ^{[1
]}

Estenssoro, Elisa ^{[7
]}

Fan, Eddy ^{[8
]}

Ferreira, Juliana Carvalho ^{[9
,10
,11
]}

Laffey, John G. ^{[12
,13
]}

Martin-Loeches, Ignacio ^{[14
,15
]}

Motos, Ana ^{[16
,17
,28
]}

Pham, Tai ^{[18
,19
]}

Penuelas, Oscar ^{[17
,20
]}

Pesenti, Antonio ^{[21
]}

Pisani, Luigi ^{[1
,22
,24
]}

Serpa Neto, Ary ^{[4
,23
]}

Schultz, Marcus J. ^{[1
,24
,25
,26
,27
]}

Torres, Antoni ^{[16
,17
,28
,29
]}

Tsonas, Anissa M. ^{[1
]}

Paulus, Frederique ^{[1
,30
]}

van Meenen, David M. P. ^{[1
,31
]}

机构：

[1] Locat AMC, Amsterdam Univ Med Ctr, Dept Intens Care, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands

[2] Rode Kruis Ziekenhuis, Dept Intens Care, Beverwijk, Netherlands

[3] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Dept Emergency Med, Sao Paulo, Brazil

[4] Hosp Israelita Albert Einstein, Dept Intens Care, Sao Paulo, Brazil

[5] Univ Trento, Ctr Med Sci CISMed, Trento, Italy

[6] Santa Chiara Hosp, Dept Anesthesia & Intens Care, APSS Trento, Trento, Italy

[7] Hosp Interzonal Agudos Gen San Martin La Plata, Dept Intens Care, Buenos Aires, Argentina

[8] Univ Toronto, Interdept Div Crit Care Med, Toronto, ON, Canada

[9] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Dept Pulmonol,Inst Coracao InCor, Sao Paulo, Brazil

[10] AC Camargo Canc Ctr, Dept Intens Care, Sao Paulo, Brazil

[11] Brazilian Res Intens Care Network BRICNet, Sao Paulo, Brazil

[12] Galway Univ Hosp, Saolta Hosp Grp, Dept Anaesthesiol & Intens Care, Galway, Ireland

[13] Univ Galway, Sch Med, Galway, Ireland

[14] St James Hosp, Dept Intens Care, Multidisciplinary Intens Care Res Org MICRO, Dublin, Ireland

[15] Hosp Clin Barcelona, Dept Intens Care, Barcelona, Spain

[16] Hosp Clin Barcelona, IDIBAPS, Dept Pulmonol, Barcelona, Spain

[17] Inst Hlth Carlos III, Ctr Invest Biomed Red Enfermedades Resp CIBERES, Madrid, Spain

[18] Univ Paris Saclay, Equipe Epidemiol Resp Integrat, Paris, France

[19] Hop Bicetre, Grp Rech Clin CARMAS, FHU SEPSIS, Serv Med Intens Reanimat,DMU CORREVE, Paris, France

[20] Hosp Univ Getafe, Dept Intens Care, Getafe, Spain

[21] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Milan, Italy

[22] Miulli Reg Hosp, Dept Anesthesia & Intens Care, Acquaviva Delle Fonti, Italy

[23] Monash Univ, Australian & New Zealand Intens Care Res Ctr ANZI, Melbourne, Vic, Australia

[24] Mahidol Univ, Mahidol Oxford Trop Med Res Unit MORU, Bangkok, Thailand

[25] Univ Oxford, Nuffield Dept Med, Oxford, England

[26] Med Univ Vienna, Dept Anesthesia Gen Intens Care & Pain Management, Div Cardiothorac & Vasc Anesthesia & Crit Care Me, Vienna, Austria

[27] Locat AMC, Amsterdam UMC, Lab Expt Intens Care & Anaesthesiol LEICA, Amsterdam, Netherlands

[28] Univ Barcelona, Barcelona, Spain

[29] Catalan Inst Res & Adv Studies ICREA, Barcelona, Spain

[30] Amsterdam Univ Appl Sci, Fac Hlth, Ctr Expertise Urban Vital, Amsterdam, Netherlands

[31] Locat AMC, Amsterdam UMC, Dept Anaesthesiol, Amsterdam, Netherlands

来源：

RESPIRATORY RESEARCH | 2024年 / 25卷 / 01期

关键词：

Acute respiratory distress syndrome; ARDS; COVID-19; Critical care; Mechanical ventilation; Ventilation management; RESPIRATORY-DISTRESS-SYNDROME; MECHANICAL POWER; MORTALITY; CARE; PRESSURE;

D O I：

10.1186/s12931-024-02910-2

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Background Ventilation management may differ between COVID-19 ARDS (COVID-ARDS) patients and patients with pre-COVID ARDS (CLASSIC-ARDS); it is uncertain whether associations of ventilation management with outcomes for CLASSIC-ARDS also exist in COVID-ARDS. Methods Individual patient data analysis of COVID-ARDS and CLASSIC-ARDS patients in six observational studies of ventilation, four in the COVID-19 pandemic and two pre-pandemic. Descriptive statistics were used to compare epidemiology and ventilation characteristics. The primary endpoint were key ventilation parameters; other outcomes included mortality and ventilator-free days and alive (VFD-60) at day 60. Results This analysis included 6702 COVID-ARDS patients and 1415 CLASSIC-ARDS patients. COVID-ARDS patients received lower median VT (6.6 [6.0 to 7.4] vs 7.3 [6.4 to 8.5] ml/kg PBW; p < 0.001) and higher median PEEP (12.0 [10.0 to 14.0] vs 8.0 [6.0 to 10.0] cm H2O; p < 0.001), at lower median Delta P (13.0 [10.0 to 15.0] vs 16.0 [IQR 12.0 to 20.0] cm H2O; p < 0.001) and higher median Crs (33.5 [26.6 to 42.1] vs 28.1 [21.6 to 38.4] mL/cm H2O; p < 0.001). Following multivariable adjustment, higher Delta P had an independent association with higher 60-day mortality and less VFD-60 in both groups. Higher PEEP had an association with less VFD-60, but only in COVID-ARDS patients. Conclusions Our findings show important differences in key ventilation parameters and associations thereof with outcomes between COVID-ARDS and CLASSIC-ARDS. Trial registrationClinicaltrials.gov (identifier NCT05650957), December 14, 2022.

引用

页数：11

共 37 条

[1] Driving Pressure and Survival in the Acute Respiratory Distress Syndrome [J].

Amato, Marcelo B. P. ;

Meade, Maureen O. ;

Slutsky, Arthur S. ;

Brochard, Laurent ;

Costa, Eduardo L. V. ;

Schoenfeld, David A. ;

Stewart, Thomas E. ;

Briel, Matthias ;

Talmor, Daniel ;

Mercat, Alain ;

Richard, Jean-Christophe M. ;

Carvalho, Carlos R. R. ;

Brower, Roy G. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (08) :747-755

[2] Clinical outcomes of patients requiring ventilatory support in Brazilian intensive care units: a multicenter, prospective, cohort study [J].

Azevedo, Luciano C. P. ;

Park, Marcelo ;

Salluh, Jorge I. F. ;

Rea-Neto, Alvaro ;

Souza-Dantas, Vicente C. ;

Varaschin, Pedro ;

Oliveira, Mirella C. ;

Tierno, Paulo Fernando G. M. M. ;

dal-Pizzol, Felipe ;

Silva, Ulysses V. A. ;

Knibel, Marcos ;

Nassar, Antonio P., Jr. ;

Alves, Rossine A. ;

Ferreira, Juliana C. ;

Teixeira, Cassiano ;

Rezende, Valeria ;

Martinez, Amadeu ;

Luciano, Paula M. ;

Schettino, Guilherme ;

Soares, Marcio .

CRITICAL CARE, 2013, 17 (02)

[3] Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries [J].

Bellani, Giacomo ;

Laffey, John G. ;

Pham, Tai ;

Fan, Eddy ;

Brochard, Laurent ;

Esteban, Andres ;

Gattinoni, Luciano ;

van Haren, Frank ;

Larsson, Anders ;

McAuley, Daniel F. ;

Ranieri, Marco ;

Rubenfeld, Gordon ;

Thompson, B. Taylor ;

Wrigge, Hermann ;

Slutsky, Arthur S. ;

Pesenti, Antonio .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2016, 315 (08) :788-800

[4] Ventilation management and clinical outcomes in invasively ventilated patients with COVID-19 (PRoVENT-COVID): a national, multicentre, observational cohort study [J].

Botta, Michela ;

Tsonas, Anissa M. ;

Pillay, Janesh ;

Boers, Leonoor S. ;

Algera, Anna Geke ;

Bos, Lieuwe D. J. ;

Dongelmans, Dave A. ;

Hollmann, Marcus W. ;

Horn, Janneke ;

Vlaar, Alexander P. J. ;

Schultz, Marcus J. ;

Neto, Ary Serpa ;

Paulus, Frederique .

LANCET RESPIRATORY MEDICINE, 2021, 9 (02) :139-148

[5] Comparison of outcome and characteristics between 6343 COVID-19 patients and 2256 other community-acquired viral pneumonia patients admitted to Dutch ICUs [J].

Brinkman, S. ;

Termorshuizen, F. ;

Dongelmans, D. A. ;

Bakhshi-Raiez, F. ;

Arbous, M. S. ;

de Lange, D. W. ;

de Keizer, N. F. ;

Verbiest, D. P. ;

te Velde, L. F. ;

van Driel, E. M. ;

Rijpstra, T. ;

Elbers, P. W. G. ;

Houwink, A. P., I ;

Georgieva, L. ;

Verweij, E. ;

de Jong, R. M. ;

van Iersel, F. M. ;

Koning, T. J. J. ;

Rengers, E. ;

Kusadasi, N. ;

Erkamp, M. L. ;

van den Berg, R. ;

Jacobs, C. J. M. G. ;

Epker, J. L. ;

Rijkeboer, A. A. ;

de Bruin, M. T. ;

Spronk, P. ;

Draisma, A. ;

Versluis, D. J. ;

van den Berg, A. E. ;

Vrolijk-de Mos, M. ;

Lens, J. A. ;

Pruijsten, R., V ;

Kieft, H. ;

Rozendaal, J. ;

Nooteboom, F. ;

Boer, D. P. ;

Janssen, I. T. A. ;

van Gulik, L. ;

Koetsier, M. P. ;

Silderhuis, V. M. ;

Schnabel, R. M. ;

Drogt, I ;

de Ruijter, W. ;

Bosman, R. J. ;

Frenzel, T. ;

Urlings-Strop, L. C. ;

Dijkhuizen, A. ;

Hene, I. Z. ;

de Meijer, A. R. .

JOURNAL OF CRITICAL CARE, 2022, 68 :76-82

[6]

Brown-Brumfield Diana, 2010, AORN J, V91, P610, DOI 10.1016/j.aorn.2010.03.002

[7] Effect of Lung Recruitment and Titrated Positive End-Expiratory Pressure (PEEP) vs Low PEEP on Mortality in Patients With Acute Respiratory Distress Syndrome A Randomized Clinical Trial [J].

Cavalcanti, Alexandre Biasi ;

Suzumura, Erica Aranha ;

Laranjeira, Ligia Nasi ;

Paisani, Denise de Moraes ;

Damiani, Lucas Petri ;

Guimaraes, Helio Penna ;

Romano, Edson Renato ;

Regenga, Marisa de Moraes ;

Taniguchi, Luzia Noriko Takahashi ;

Teixeira, Cassiano ;

de Oliveira, Roselaine Pinheiro ;

Machado, Flavia Ribeiro ;

Diaz-Quijano, Fredi Alexander ;

de Alencar Filho, Meton Soares ;

Maia, Israel Silva ;

Caser, Eliana Bernardete ;

de Oliveira Filho, Wilson ;

Borges, Marcos de Carvalho ;

Martins, Priscilla de Aquino ;

Matsui, Mirna ;

Ospina-Tascon, Gustavo Adolfo ;

Giancursi, Thiago Simoes ;

Giraldo-Rarnirez, Nelson Dario ;

Rios Vieira, Silvia Regina ;

Pasquotto de Lima Assef, Maria da Graca ;

Hasan, Mohd Shahnaz ;

Szczeklik, Wojciech ;

Rios, Fernando ;

Amato, Marcelo Britto Passos ;

Berwanger, Otavio ;

Ribeiro de Carvalho, Carlos Roberto .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2017, 318 (14) :1335-1345

[8] Physiological and quantitative CT-scan characterization of COVID-19 and typical ARDS: a matched cohort study [J].

Chiumello, Davide ;

Busana, Mattia ;

Coppola, Silvia ;

Romitti, Federica ;

Formenti, Paolo ;

Bonifazi, Matteo ;

Pozzi, Tommaso ;

Palumbo, Maria Michela ;

Cressoni, Massimo ;

Herrmann, Peter ;

Meissner, Konrad ;

Quintel, Michael ;

Camporota, Luigi ;

Marini, John J. ;

Gattinoni, Luciano .

INTENSIVE CARE MEDICINE, 2020, 46 (12) :2187-2196

[9] Personalised mechanical ventilation tailored to lung morphology versus low positive end-expiratory pressure for patients with acute respiratory distress syndrome in France (the LIVE study): a multicentre, single-blind, randomised controlled trial [J].

Constantin, Jean-Michel ;

Jabaudon, Matthieu ;

Lefrant, Jean-Yves ;

Jaber, Samir ;

Quenot, Jean-Pierre ;

Langeron, Olivier ;

Ferrandiere, Martine ;

Grelon, Fabien ;

Seguin, Philippe ;

Ichai, Carole ;

Veber, Benoit ;

Souweine, Bertrand ;

Uberti, Thomas ;

Lasocki, Sigismond ;

Legay, Francois ;

Leone, Marc ;

Eisenmann, Nathanael ;

Dahyot-Fizelier, Claire ;

Dupont, Herve ;

Asehnoune, Karim ;

Sossou, Achille ;

Chanques, Gerald ;

Muller, Laurent ;

Bazin, Jean-Etienne ;

Monsel, Antoine ;

Borao, Lucile ;

Garcier, Jean-Marc ;

Rouby, Jean-Jacques ;

Pereira, Bruno ;

Futier, Emmanuel .

LANCET RESPIRATORY MEDICINE, 2019, 7 (10) :870-880

[10] Ventilatory Variables and Mechanical Power in Patients with Acute Respiratory Distress Syndrome [J].

Costa, Eduardo L., V ;

Slutsky, Arthur S. ;

Brochard, Laurent J. ;

Brower, Roy ;

Serpa-Neto, Ary ;

Cavalcanti, Alexandre B. ;

Mercat, Alain ;

Meade, Maureen ;

Morais, Caio C. A. ;

Goligher, Ewan ;

Carvalho, Carlos R. R. ;

Amato, Marcelo B. P. .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2021, 204 (03) :303-311

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