Cargando…

Critical patients COVID-19 has changed the management and outcomes in the ICU after 1 year of the pandemic? A multicenter, prospective, observational study

OBJECTIVE: To compare the clinical characteristics, treatments, and evolution of critical patients with COVID-19 pneumonia treated in Intensive Care Units (ICU) after one year of pandemic. METHODOLOGY: Multicenter, prospective study, which included critical COVID-19 patients in 9 ICUs in northwester...

Descripción completa

Detalles Bibliográficos
Autores principales: Rama-Maceiras, Pablo, Sanduende, Yolanda, Taboada, Manuel, Casero, María, Leal, Sonsoles, Pita-Romero, Rafael, Fernández, Ricardo, López, Eva, López, José Antonio, Pita, Elvira, Tubío, Ana, Rodríguez, Arancha, Varela, Marina, Campaña, Daniel, Delgado, Carla, Lombardía, Mónica, Villar, Eva, Blanco, Pilar, Martínez, Adrián, Sarmiento, Ana, Díaz, Pilar, Ojea, María, Rodríguez, Ángel, Mouriz, Lorena, Cid, Milagros, Ramos, Lorena, Seoane-Pillado, Teresa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9903149/
https://www.ncbi.nlm.nih.gov/pubmed/35907774
http://dx.doi.org/10.1016/j.eimce.2022.07.003
_version_ 1784883417903529984
author Rama-Maceiras, Pablo
Sanduende, Yolanda
Taboada, Manuel
Casero, María
Leal, Sonsoles
Pita-Romero, Rafael
Fernández, Ricardo
López, Eva
López, José Antonio
Pita, Elvira
Tubío, Ana
Rodríguez, Arancha
Varela, Marina
Campaña, Daniel
Delgado, Carla
Lombardía, Mónica
Villar, Eva
Blanco, Pilar
Martínez, Adrián
Sarmiento, Ana
Díaz, Pilar
Ojea, María
Rodríguez, Ángel
Mouriz, Lorena
Cid, Milagros
Ramos, Lorena
Seoane-Pillado, Teresa
author_facet Rama-Maceiras, Pablo
Sanduende, Yolanda
Taboada, Manuel
Casero, María
Leal, Sonsoles
Pita-Romero, Rafael
Fernández, Ricardo
López, Eva
López, José Antonio
Pita, Elvira
Tubío, Ana
Rodríguez, Arancha
Varela, Marina
Campaña, Daniel
Delgado, Carla
Lombardía, Mónica
Villar, Eva
Blanco, Pilar
Martínez, Adrián
Sarmiento, Ana
Díaz, Pilar
Ojea, María
Rodríguez, Ángel
Mouriz, Lorena
Cid, Milagros
Ramos, Lorena
Seoane-Pillado, Teresa
author_sort Rama-Maceiras, Pablo
collection PubMed
description OBJECTIVE: To compare the clinical characteristics, treatments, and evolution of critical patients with COVID-19 pneumonia treated in Intensive Care Units (ICU) after one year of pandemic. METHODOLOGY: Multicenter, prospective study, which included critical COVID-19 patients in 9 ICUs in northwestern Spain. The clinical characteristics, treatments, and evolution of patients admitted to the ICU during the months of March-April 2020 (period 1) were compared with patients admitted in January-February 2021 (period 2). RESULTS: 337 patients were included (98 in period 1 and 239 in period 2). In period 2, fewer patients required invasive mechanical ventilation (IMV) (65% vs 84%, p < 0.001), using high-flow nasal cannulas (CNAF) more frequently (70% vs 7%, p < 0.001), ventilation non-invasive mechanical (NIMV) (40% vs 14%, p < 0.001), corticosteroids (100% vs 96%, p = 0.007) and prone position in both awake (42% vs 28%, p = 0.012), and intubated patients (67% vs 54%, p = 0.034). The days of IMV, ICU stay and hospital stay were lower in period 2. Mortality was similar in the two periods studied (16% vs 17%). CONCLUSIONS: After 1 year of pandemic, we observed that in patients admitted to the ICU, CNAF, NIMV, use of the prone position, and corticosteroids have been used more frequently, reducing the number of patients in IMV, and the length of stay in the ICU and hospital stay. Mortality was similar in the two study periods.
format Online
Article
Text
id pubmed-9903149
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U.
record_format MEDLINE/PubMed
spelling pubmed-99031492023-02-07 Critical patients COVID-19 has changed the management and outcomes in the ICU after 1 year of the pandemic? A multicenter, prospective, observational study Rama-Maceiras, Pablo Sanduende, Yolanda Taboada, Manuel Casero, María Leal, Sonsoles Pita-Romero, Rafael Fernández, Ricardo López, Eva López, José Antonio Pita, Elvira Tubío, Ana Rodríguez, Arancha Varela, Marina Campaña, Daniel Delgado, Carla Lombardía, Mónica Villar, Eva Blanco, Pilar Martínez, Adrián Sarmiento, Ana Díaz, Pilar Ojea, María Rodríguez, Ángel Mouriz, Lorena Cid, Milagros Ramos, Lorena Seoane-Pillado, Teresa Enferm Infecc Microbiol Clin (Engl Ed) Original Article OBJECTIVE: To compare the clinical characteristics, treatments, and evolution of critical patients with COVID-19 pneumonia treated in Intensive Care Units (ICU) after one year of pandemic. METHODOLOGY: Multicenter, prospective study, which included critical COVID-19 patients in 9 ICUs in northwestern Spain. The clinical characteristics, treatments, and evolution of patients admitted to the ICU during the months of March-April 2020 (period 1) were compared with patients admitted in January-February 2021 (period 2). RESULTS: 337 patients were included (98 in period 1 and 239 in period 2). In period 2, fewer patients required invasive mechanical ventilation (IMV) (65% vs 84%, p < 0.001), using high-flow nasal cannulas (CNAF) more frequently (70% vs 7%, p < 0.001), ventilation non-invasive mechanical (NIMV) (40% vs 14%, p < 0.001), corticosteroids (100% vs 96%, p = 0.007) and prone position in both awake (42% vs 28%, p = 0.012), and intubated patients (67% vs 54%, p = 0.034). The days of IMV, ICU stay and hospital stay were lower in period 2. Mortality was similar in the two periods studied (16% vs 17%). CONCLUSIONS: After 1 year of pandemic, we observed that in patients admitted to the ICU, CNAF, NIMV, use of the prone position, and corticosteroids have been used more frequently, reducing the number of patients in IMV, and the length of stay in the ICU and hospital stay. Mortality was similar in the two study periods. Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. 2023-02 2022-07-28 /pmc/articles/PMC9903149/ /pubmed/35907774 http://dx.doi.org/10.1016/j.eimce.2022.07.003 Text en © 2021 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. 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 Original Article
Rama-Maceiras, Pablo
Sanduende, Yolanda
Taboada, Manuel
Casero, María
Leal, Sonsoles
Pita-Romero, Rafael
Fernández, Ricardo
López, Eva
López, José Antonio
Pita, Elvira
Tubío, Ana
Rodríguez, Arancha
Varela, Marina
Campaña, Daniel
Delgado, Carla
Lombardía, Mónica
Villar, Eva
Blanco, Pilar
Martínez, Adrián
Sarmiento, Ana
Díaz, Pilar
Ojea, María
Rodríguez, Ángel
Mouriz, Lorena
Cid, Milagros
Ramos, Lorena
Seoane-Pillado, Teresa
Critical patients COVID-19 has changed the management and outcomes in the ICU after 1 year of the pandemic? A multicenter, prospective, observational study
title Critical patients COVID-19 has changed the management and outcomes in the ICU after 1 year of the pandemic? A multicenter, prospective, observational study
title_full Critical patients COVID-19 has changed the management and outcomes in the ICU after 1 year of the pandemic? A multicenter, prospective, observational study
title_fullStr Critical patients COVID-19 has changed the management and outcomes in the ICU after 1 year of the pandemic? A multicenter, prospective, observational study
title_full_unstemmed Critical patients COVID-19 has changed the management and outcomes in the ICU after 1 year of the pandemic? A multicenter, prospective, observational study
title_short Critical patients COVID-19 has changed the management and outcomes in the ICU after 1 year of the pandemic? A multicenter, prospective, observational study
title_sort critical patients covid-19 has changed the management and outcomes in the icu after 1 year of the pandemic? a multicenter, prospective, observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9903149/
https://www.ncbi.nlm.nih.gov/pubmed/35907774
http://dx.doi.org/10.1016/j.eimce.2022.07.003
work_keys_str_mv AT ramamaceiraspablo criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT sanduendeyolanda criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT taboadamanuel criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT caseromaria criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT lealsonsoles criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT pitaromerorafael criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT fernandezricardo criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT lopezeva criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT lopezjoseantonio criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT pitaelvira criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT tubioana criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT rodriguezarancha criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT varelamarina criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT campanadaniel criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT delgadocarla criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT lombardiamonica criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT villareva criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT blancopilar criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT martinezadrian criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT sarmientoana criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT diazpilar criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT ojeamaria criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT rodriguezangel criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT mourizlorena criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT cidmilagros criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT ramoslorena criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy
AT seoanepilladoteresa criticalpatientscovid19haschangedthemanagementandoutcomesintheicuafter1yearofthepandemicamulticenterprospectiveobservationalstudy