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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Can+J+Anaesth 2021 ; 68 (2): 204-213 Nephropedia Template TP
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Experiences initiales avec les patients atteints de la COVID-19 en etat critique a Montreal #MMPMID32935329
Cavayas YA; Noel A; Brunette V; Williamson D; Frenette AJ; Arsenault C; Bellemare P; Lagrenade-Verdant C; LeGuillan S; Levesque E; Lamarche Y; Giasson M; Rico P; Beaulieu Y; Marsolais P; Serri K; Bernard F; Albert M
Can J Anaesth 2021[Feb]; 68 (2): 204-213 PMID32935329show ga
PURPOSE: Montreal has been the epicentre of the coronavirus disease (COVID-19) pandemic in Canada. Given the regional disparities in incidence and mortality in the general population, we aimed to describe local characteristics, treatments, and outcomes of critically ill COVID-19 patients in Montreal. METHODS: A single-centre retrospective cohort of consecutive adult patients admitted to the intensive care unit (ICU) of Hopital du Sacre-Coeur de Montreal with confirmed COVID-19 were included. RESULTS: Between 20 March and 13 May 2020, 75 patients were admitted, with a median [interquartile range (IQR)] age of 62 [53-72] yr and high rates of obesity (47%), hypertension (67%), and diabetes (37%). Healthcare-related infections were responsible for 35% of cases. The median [IQR] day 1 sequential organ failure assessment score was 6 [3-7]. Invasive mechanical ventilation (IMV) was used in 57% of patients for a median [IQR] of 11 [5-22] days. Patients receiving IMV were characterized by a moderately decreased median [IQR] partial pressure of oxygen:fraction of inspired oxygen (day 1 PaO(2):F(i)O(2) = 177 [138-276]; day 10 = 173 [147-227]) and compliance (day 1 = 48 [38-58] mL/cmH(2)O; day 10 = 34 [28-42] mL/cmH(2)O) and very elevated estimated dead space fraction (day 1 = 0.60 [0.53-0.67]; day 10 = 0.72 [0.69-0.79]). Overall hospital mortality was 25%, and 21% in the IMV patients. Mortality was 82% in patients >/= 80 yr old. CONCLUSIONS: Characteristics and outcomes of critically ill patients with COVID-19 in Montreal were similar to those reported in the existing literature. We found an increased physiologic dead space, supporting the hypothesis that pulmonary vascular injury may be central to COVID-19-induced lung damage.
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Can+J+Anaesth 2021 ; 68 (2): 204-213
