The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

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  • dc.contributor.author Torres Martí, Antoni
  • dc.contributor.author Marin Corral, Judith
  • dc.contributor.author Barbé, Ferran
  • dc.contributor.author CIBERESUCICOVID Project (COV20/00110, ISCIII)
  • dc.date.accessioned 2022-05-31T06:58:45Z
  • dc.date.available 2022-05-31T06:58:45Z
  • dc.date.issued 2021
  • dc.description.abstract Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Torres A, Motos A, Riera J, Fernández-Barat L, Ceccato A, Pérez-Arnal R, et al. The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients. Crit Care. 2021 Sep 13; 25(1): 331. DOI: 10.1186/s13054-021-03727-x
  • dc.identifier.doi http://dx.doi.org/10.1186/s13054-021-03727-x
  • dc.identifier.issn 1364-8535
  • dc.identifier.uri http://hdl.handle.net/10230/53318
  • dc.language.iso eng
  • dc.publisher BioMed Central
  • dc.rights Copyright © The Author(s) 2021. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword COVID-19
  • dc.subject.keyword Coronavirus
  • dc.subject.keyword Mechanical ventilation
  • dc.subject.keyword SARS-CoV-2
  • dc.subject.keyword Ventilatory ratio
  • dc.title The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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