Cargando…
Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany
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 wit...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590821/ https://www.ncbi.nlm.nih.gov/pubmed/33250401 http://dx.doi.org/10.1016/j.aucc.2020.10.009 |
_version_ | 1783600875857510400 |
---|---|
author | Roedl, Kevin Jarczak, Dominik Thasler, Liina Bachmann, Martin Schulte, Frank Bein, Berthold Weber, Christian Friedrich Schäfer, Ulrich Veit, Carsten Hauber, Hans-Peter Kopp, Sebastian Sydow, Karsten de Weerth, Andreas Bota, Marc Schreiber, Rüdiger Detsch, Oliver Rogmann, Jan-Peer Frings, Daniel Sensen, Barbara Burdelski, Christoph Boenisch, Olaf Nierhaus, Axel de Heer, Geraldine Kluge, Stefan |
author_facet | Roedl, Kevin Jarczak, Dominik Thasler, Liina Bachmann, Martin Schulte, Frank Bein, Berthold Weber, Christian Friedrich Schäfer, Ulrich Veit, Carsten Hauber, Hans-Peter Kopp, Sebastian Sydow, Karsten de Weerth, Andreas Bota, Marc Schreiber, Rüdiger Detsch, Oliver Rogmann, Jan-Peer Frings, Daniel Sensen, Barbara Burdelski, Christoph Boenisch, Olaf Nierhaus, Axel de Heer, Geraldine Kluge, Stefan |
author_sort | Roedl, Kevin |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7590821 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-75908212020-10-28 Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany Roedl, Kevin Jarczak, Dominik Thasler, Liina Bachmann, Martin Schulte, Frank Bein, Berthold Weber, Christian Friedrich Schäfer, Ulrich Veit, Carsten Hauber, Hans-Peter Kopp, Sebastian Sydow, Karsten de Weerth, Andreas Bota, Marc Schreiber, Rüdiger Detsch, Oliver Rogmann, Jan-Peer Frings, Daniel Sensen, Barbara Burdelski, Christoph Boenisch, Olaf Nierhaus, Axel de Heer, Geraldine Kluge, Stefan Aust Crit Care Research Paper 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. Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. 2021-03 2020-10-27 /pmc/articles/PMC7590821/ /pubmed/33250401 http://dx.doi.org/10.1016/j.aucc.2020.10.009 Text en © 2020 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Research Paper Roedl, Kevin Jarczak, Dominik Thasler, Liina Bachmann, Martin Schulte, Frank Bein, Berthold Weber, Christian Friedrich Schäfer, Ulrich Veit, Carsten Hauber, Hans-Peter Kopp, Sebastian Sydow, Karsten de Weerth, Andreas Bota, Marc Schreiber, Rüdiger Detsch, Oliver Rogmann, Jan-Peer Frings, Daniel Sensen, Barbara Burdelski, Christoph Boenisch, Olaf Nierhaus, Axel de Heer, Geraldine Kluge, Stefan Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany |
title | Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany |
title_full | Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany |
title_fullStr | Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany |
title_full_unstemmed | Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany |
title_short | Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany |
title_sort | mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: a multicentric study in germany |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590821/ https://www.ncbi.nlm.nih.gov/pubmed/33250401 http://dx.doi.org/10.1016/j.aucc.2020.10.009 |
work_keys_str_mv | AT roedlkevin mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT jarczakdominik mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT thaslerliina mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT bachmannmartin mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT schultefrank mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT beinberthold mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT weberchristianfriedrich mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT schaferulrich mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT veitcarsten mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT hauberhanspeter mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT koppsebastian mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT sydowkarsten mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT deweerthandreas mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT botamarc mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT schreiberrudiger mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT detscholiver mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT rogmannjanpeer mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT fringsdaniel mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT sensenbarbara mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT burdelskichristoph mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT boenischolaf mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT nierhausaxel mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT deheergeraldine mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany AT klugestefan mechanicalventilationandmortalityamong223criticallyillpatientswithcoronavirusdisease2019amulticentricstudyingermany |