Dead space estimates may not be independently associated with 28-day mortality in COVID-19 ARDS
- Resource Type
- Authors
- Morales-Quinteros, Luis; Neto, Ary Serpa; Artigas, Antonio; Blanch, Lluis; Botta, Michela; Kaufman, David A; Schultz, Marcus J; Tsonas, Anissa M; Paulus, Frederique; Bos, Lieuwe D; Study group members AMC; de Klerk, Eline S.; Breel, Jennifer
- Source
- Critical Care, 25(1):171. Springer Science + Business Media
Critical Care, 25(1):171. BioMed Central Ltd
Critical Care, Vol 25, Iss 1, Pp 1-13 (2021)
Critical care (London, England), 25(1):171. Springer Science + Business Media
Critical Care
on behalf of the PRoVENT-COVID Study Group 2021, ' Dead space estimates may not be independently associated with 28-day mortality in COVID-19 ARDS ', Critical Care, vol. 25, no. 1, 171 . https://doi.org/10.1186/s13054-021-03570-0
Critical Care, 25:171. BioMed Central
Critical care (London, England), 25(1):171. BMC
- Subject
- ARDS
ademhalingsfunctietesten
intensive care units
medicine.medical_treatment
Dead space
Prognostication
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
VOLUMETRIC CAPNOGRAPHY
FRACTION
Respiratory Distress Syndrome/etiology
intensive care afdelingen
0302 clinical medicine
patient acuity
adults
vrouwen
Respiratory dead space
zorgbehoefte
Acute respiratory distress syndrome
mannen
Respiration
respiratory function tests
volwassenen
Medical emergencies. Critical care. Intensive care. First aid
dode ruimte
respiratory distress syndrome
PROGNOSTIC VALUE
female
prognose
Artificial
Breathing
COVID-19/complications
Adult
medicine.medical_specialty
respiratory mechanics
etiology
Respiratory Dead Space
pCO2
ACUTE LUNG INJURY
03 medical and health sciences
male
Intensive care
medicine
Humans
artificial respiration
Mortality
Retrospective Studies
Mechanical ventilation
RC86-88.9
business.industry
Research
biomarkers
COVID-19
Ventilatory ratio
Retrospective cohort study
medicine.disease
Respiration, Artificial
roc curve
030228 respiratory system
Emergency medicine
kunstmatige ademhaling
prognosis
ademhalingstechnieken
etiologie
business
patienten
- Language
- English
- ISSN
- 1364-8535
1466-609X
Background Estimates for dead space ventilation have been shown to be independently associated with an increased risk of mortality in the acute respiratory distress syndrome and small case series of COVID-19-related ARDS. Methods Secondary analysis from the PRoVENT-COVID study. The PRoVENT-COVID is a national, multicenter, retrospective observational study done at 22 intensive care units in the Netherlands. Consecutive patients aged at least 18 years were eligible for participation if they had received invasive ventilation for COVID-19 at a participating ICU during the first month of the national outbreak in the Netherlands. The aim was to quantify the dynamics and determine the prognostic value of surrogate markers of wasted ventilation in patients with COVID-19-related ARDS. Results A total of 927 consecutive patients admitted with COVID-19-related ARDS were included in this study. Estimations of wasted ventilation such as the estimated dead space fraction (by Harris–Benedict and direct method) and ventilatory ratio were significantly higher in non-survivors than survivors at baseline and during the following days of mechanical ventilation (p 2 ratio was lower in non-survivors than in survivors (p 2 ratio. After adjustment for a base risk model that included chronic comorbidities and ventilation- and oxygenation-parameters, none of the dead space estimates measured at the start of ventilation or the following days were significantly associated with 28-day mortality. Conclusions There is significant impairment of ventilation in the early course of COVID-19-related ARDS but quantification of this impairment does not add prognostic information when added to a baseline risk model. Trial registration: ISRCTN04346342. Registered 15 April 2020. Retrospectively registered.