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10.1007/s00134-020-06192-2

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suck abstract from ncbi


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pmid32728965      Intensive+Care+Med 2020 ; 46 (12): 2200-2211
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  • Clinical features, ventilatory management, and outcome of ARDS caused by COVID-19 are similar to other causes of ARDS #MMPMID32728965
  • Ferrando C; Suarez-Sipmann F; Mellado-Artigas R; Hernandez M; Gea A; Arruti E; Aldecoa C; Martinez-Palli G; Martinez-Gonzalez MA; Slutsky AS; Villar J
  • Intensive Care Med 2020[Dec]; 46 (12): 2200-2211 PMID32728965show ga
  • PURPOSE: The main characteristics of mechanically ventilated ARDS patients affected with COVID-19, and the adherence to lung-protective ventilation strategies are not well known. We describe characteristics and outcomes of confirmed ARDS in COVID-19 patients managed with invasive mechanical ventilation (MV). METHODS: This is a multicenter, prospective, observational study in consecutive, mechanically ventilated patients with ARDS (as defined by the Berlin criteria) affected with with COVID-19 (confirmed SARS-CoV-2 infection in nasal or pharyngeal swab specimens), admitted to a network of 36 Spanish and Andorran intensive care units (ICUs) between March 12 and June 1, 2020. We examined the clinical features, ventilatory management, and clinical outcomes of COVID-19 ARDS patients, and compared some results with other relevant studies in non-COVID-19 ARDS patients. RESULTS: A total of 742 patients were analysed with complete 28-day outcome data: 128 (17.1%) with mild, 331 (44.6%) with moderate, and 283 (38.1%) with severe ARDS. At baseline, defined as the first day on invasive MV, median (IQR) values were: tidal volume 6.9 (6.3-7.8) ml/kg predicted body weight, positive end-expiratory pressure 12 (11-14) cmH(2)O. Values of respiratory system compliance 35 (27-45) ml/cmH(2)O, plateau pressure 25 (22-29) cmH(2)O, and driving pressure 12 (10-16) cmH(2)O were similar to values from non-COVID-19 ARDS patients observed in other studies. Recruitment maneuvers, prone position and neuromuscular blocking agents were used in 79%, 76% and 72% of patients, respectively. The risk of 28-day mortality was lower in mild ARDS [hazard ratio (RR) 0.56 (95% CI 0.33-0.93), p = 0.026] and moderate ARDS [hazard ratio (RR) 0.69 (95% CI 0.47-0.97), p = 0.035] when compared to severe ARDS. The 28-day mortality was similar to other observational studies in non-COVID-19 ARDS patients. CONCLUSIONS: In this large series, COVID-19 ARDS patients have features similar to other causes of ARDS, compliance with lung-protective ventilation was high, and the risk of 28-day mortality increased with the degree of ARDS severity.
  • |Adult[MESH]
  • |Analysis of Variance[MESH]
  • |COVID-19/*physiopathology/therapy[MESH]
  • |Correlation of Data[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Proportional Hazards Models[MESH]
  • |Prospective Studies[MESH]
  • |Respiration, Artificial/methods[MESH]
  • |Respiratory Distress Syndrome/*physiopathology/therapy[MESH]
  • |Severity of Illness Index[MESH]
  • |Spain[MESH]


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