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10.1016/j.aucc.2020.10.009

http://scihub22266oqcxt.onion/10.1016/j.aucc.2020.10.009
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33250401!7590821!33250401
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suck abstract from ncbi


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pmid33250401      Aust+Crit+Care 2021 ; 34 (2): 167-175
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  • Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany #MMPMID33250401
  • Roedl K; Jarczak D; Thasler L; Bachmann M; Schulte F; Bein B; Weber CF; Schafer U; Veit C; Hauber HP; Kopp S; Sydow K; de Weerth A; Bota M; Schreiber R; Detsch O; Rogmann JP; Frings D; Sensen B; Burdelski C; Boenisch O; Nierhaus A; de Heer G; Kluge S
  • Aust Crit Care 2021[Mar]; 34 (2): 167-175 PMID33250401show ga
  • 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.
  • |*Critical Illness[MESH]
  • |*Respiration, Artificial[MESH]
  • |Aged[MESH]
  • |COVID-19/*mortality/*therapy[MESH]
  • |Female[MESH]
  • |Germany/epidemiology[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pneumonia, Viral/*mortality/*therapy/virology[MESH]
  • |Retrospective Studies[MESH]


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