Noninvasive ventilation in COVID-19 patients aged ≥ 70 years-a prospective multicentre cohort study
Polok, Kamil (Jagiellonian University Medical College)
Fronczek, Jakub (Jagiellonian University Medical College)
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Flaatten, Hans (University of Bergen)
Guidet, Bertrand (Hôpitaux de Paris)
De Lange, Dylan W. (University Utrecht)
Fjølner, Jesper (Viborg Regional Hospital)
Leaver, Susannah (St George's Hospital)
Beil, Michael (Hadassah Medical Center)
Sviri, Sigal (Hebrew University of Jerusalem)
Bruno, Raphael Romano (Heinrich-Heine-University Duesseldorf)
Wernly, Bernhard (Paracelsus Medical University of Salzburg)
Bollen Pinto, Bernardo (Geneva University Hospitals)
Schefold, Joerg C. (Bern University Hospital)
Studzińska, Dorota (Jagiellonian University Medical College)
Joannidis, Michael (Medical University Innsbruck)
Oeyen, Sandra (Universitair Ziekenhuis Gent)
Marsh, Brian (Mater Misericordiae University Hospital(Dublín, Irlanda))
Andersen, Finn H. (Norwegian University of Science and Technology)
Moreno, Rui (Universidade da Beira Interior)
Cecconi, Maurizio (Humanitas University)
Jung, Christian (Heinrich-Heine-University Duesseldorf)
Szczeklik, Wojciech (Jagiellonian University Medical College)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Noninvasive ventilation (NIV) is a promising alternative to invasive mechanical ventilation (IMV) with a particular importance amidst the shortage of intensive care unit (ICU) beds during the COVID-19 pandemic. We aimed to evaluate the use of NIV in Europe and factors associated with outcomes of patients treated with NIV. This is a substudy of COVIP study-an international prospective observational study enrolling patients aged ≥ 70 years with confirmed COVID-19 treated in ICU. We enrolled patients in 156 ICUs across 15 European countries between March 2020 and April 2021. The primary endpoint was 30-day mortality. Cohort included 3074 patients, most of whom were male (2197/3074, 71. 4%) at the mean age of 75. 7 years (SD 4. 6). NIV frequency was 25. 7% and varied from 1. 1 to 62. 0% between participating countries. Primary NIV failure, defined as need for endotracheal intubation or death within 30 days since ICU admission, occurred in 470/629 (74. 7%) of patients. Factors associated with increased NIV failure risk were higher Sequential Organ Failure Assessment (SOFA) score (OR 3. 73, 95% CI 2. 36-5. 90) and Clinical Frailty Scale (CFS) on admission (OR 1. 46, 95% CI 1. 06-2. 00). Patients initially treated with NIV (n = 630) lived for 1. 36 fewer days (95% CI − 2. 27 to − 0. 46 days) compared to primary IMV group (n = 1876). Frequency of NIV use varies across European countries. Higher severity of illness and more severe frailty were associated with a risk of NIV failure among critically ill older adults with COVID-19. Primary IMV was associated with better outcomes than primary NIV. Clinical Trial Registration , registered 19 March 2020, . The online version contains supplementary material available at 10. 1186/s13054-022-04082-1.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COVID-19 ; Elderly ; Frailty ; Intensive care unit ; Noninvasive ventilation
Publicat a:	Critical Care, Vol. 26 (july 2022) , ISSN 1466-609X

DOI: 10.1186/s13054-022-04082-1
PMID: 35869557

12 p, 1012.4 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d’Investigació i Innovació Parc Taulí (I3PT)
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