Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany

被引：77

作者：

Roedl, Kevin ^{[1
]}

Jarczak, Dominik ^{[1
]}

Thasler, Liina ^{[1
]}

Bachmann, Martin ^{[2
]}

Schulte, Frank ^{[3
]}

Bein, Berthold ^{[4
]}

Weber, Christian Friedrich ^{[5
]}

Schaefer, Ulrich ^{[6
]}

Veit, Carsten ^{[7
]}

Hauber, Hans-Peter ^{[8
]}

Kopp, Sebastian ^{[9
]}

Sydow, Karsten ^{[10
]}

de Weerth, Andreas ^{[11
]}

Bota, Marc ^{[12
]}

Schreiber, Ruediger ^{[13
]}

Detsch, Oliver ^{[14
]}

Rogmann, Jan-Peer ^{[15
]}

Frings, Daniel ^{[1
]}

Sensen, Barbara ^{[1
]}

Burdelski, Christoph ^{[1
]}

Boenisch, Olaf ^{[1
]}

Nierhaus, Axel ^{[1
]}

de Heer, Geraldine ^{[1
]}

Kluge, Stefan ^{[1
]}

机构：

[1] Univ Med Ctr Hamburg Eppendorf, Dept Intens Care Med, Martinistr 52, D-20246 Hamburg, Germany

[2] Asklepios Hosp Harburg, Dept Intens Care & Resp Med, Clin Airway Thorax & Resp Med, Hamburg, Germany

[3] Asklepios Hosp Barmbek, Weaningctr, Dept Pneumonol & Intens Care Med, Hamburg, Germany

[4] Asklepios Hosp St Georg, Dept Anaesthesiol Intens Care Emergency Med & Pai, Hamburg, Germany

[5] Asklepios Hosp Wandsbek, Dept Anaesthesiol Intens Care & Emergency Med, Hamburg, Germany

[6] Marien Hosp, Dept Cardiol Angiol & Intens Care Med, Hamburg, Germany

[7] Bundeswehr Hosp, Dept Interdisciplinary Intens Care Med, Hamburg, Germany

[8] Asklepios Hosp Altona, Dept Cardiol Pneumol & Intens Care Med, Hamburg, Germany

[9] Amalie Sieveking Hosp, Dept Anaesthesiol & Intens Care Med, Hamburg, Germany

[10] Albertinen Hosp, Dept Cardiol, Hamburg, Germany

[11] Agaples Diakonie Hosp Hamburg, Dept Internal Med, Hamburg, Germany

[12] Bethesda Hosp Bergedorf, Dept Internal Med, Hamburg, Germany

[13] Asklepios West Hosp Hamburg, Dept Anaesthesiol Intens Care & Emergency Med, Hamburg, Germany

[14] Asklepios Hosp Nord, Dept Anaesthesiol Intens Care Emergency Med & Pai, Hamburg, Germany

[15] Israelit Hosp, Dept Anaesthesiol & Intens Care Med, Hamburg, Germany

来源：

AUSTRALIAN CRITICAL CARE | 2021年 / 34卷 / 02期

关键词：

Mechanical ventilation; COVID-19; SARS-CoV-2; ARDS; Mortality; Multiple organ failure; COVID-19; SEPSIS;

D O I：

10.1016/j.aucc.2020.10.009

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: There are large uncertainties with regard to the outcome of patients with coronavirus disease 2019 (COVID-19) and mechanical ventilation (MV). High mortality (50-97%) was proposed by some groups, leading to considerable uncertainties with regard to outcomes of critically ill patients with COVID-19. Objectives: The aim was to investigate the characteristics and outcomes of critically ill patients with COVID-19 requiring intensive care unit (ICU) admission and MV. Methods: A multicentre retrospective observational cohort study at 15 hospitals in Hamburg, Germany, was performed. Critically ill adult patients with COVID-19 who completed their ICU stay between February and June 2020 were included. Patient demographics, severity of illness, and ICU course were retrospectively evaluated. Results: A total of 223 critically ill patients with COVID-19 were included. The majority, 73% (n = 163), were men; the median age was 69 (interquartile range = 58-77.5) years, with 68% (n = 151) patients having at least one chronic medical condition. Their Sequential Organ Failure Assessment score was a median of 5 (3-9) points on admission. Overall, 167 (75%) patients needed MV. Noninvasive ventilation and high -flow nasal cannula were used in 31 (14%) and 26 (12%) patients, respectively. Subsequent MV, due to noninvasive ventilation/high-flow nasal cannula therapy failure, was necessary in 46 (81%) patients. Renal replacement therapy was initiated in 33% (n = 72) of patients, and owing to severe respiratory failure, extracorporeal membrane oxygenation was necessary in 9% (n = 20) of patients. Experimental antiviral therapy was used in 9% (n = 21) of patients. Complications during the ICU stay were as follows: septic shock (40%, n = 90), heart failure (8%, n = 17), and pulmonary embolism (6%, n = 14). The length of ICU stay was a median of 13 days (5-24), and the duration of MV was 15 days (8-25). The ICU mortality was 35% (n = 78) and 44% (n = 74) among mechanically ventilated patients. Conclusion: In this multicentre observational study of 223 critically ill patients with COVID-19, the survival to ICU discharge was 65%, and it was 56% among patients requiring MV. Patients showed high rate of septic complications during their ICU stay. (c) 2020 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

引用

页码：167 / 175

页数：9

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