Epidemiology of Weaning From Invasive Mechanical Ventilation in Subjects With COVID-19.

BACKGROUND: Patients requiring mechanical ventilation due to COVID-19 have different characteristics of evolution and outcome compared to the general ICU population. Although early weaning from mechanical ventilation is associated with improved outcomes, inadequate identification of patients unable...

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Publicado en:Respiratory Care Vol. 68; no. 1; pp. 101 - 110
Autores principales: Dorado, Javier H., Navarro, Emiliano, Plotnikow, Gustavo A., Gogniat, Emiliano, Accoce, Matías
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Jan2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2023
      vid: 68
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      pub: Mary Ann Liebert, Inc.
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        atl: Epidemiology of Weaning From Invasive Mechanical Ventilation in Subjects With COVID-19.
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        au:
          Dorado, Javier H.
          Navarro, Emiliano
          Plotnikow, Gustavo A.
          Gogniat, Emiliano
          Accoce, Matías
        affil: Capítulo de Kinesiología Intensivista, Sociedad Argentina de Terapia Intensiva, CABA, Argentina
      sug:
        subj:
          Treatment Weaning
          Respiration, Artificial Methods
          COVID-19 Epidemiology
          Invasive Procedures
          Extubation, Traumatic Risk Factors
          Treatment Outcomes
          Respiratory Failure
          Multicenter Studies
          Prospective Studies
          Intensive Care Units
          Airway Management Methods
          Respiration, Artificial Classification
          Length of Stay
          Respiratory Distress Syndrome, Newborn
          Human
          Male
          Female
          Middle Age
          Aged
          Data Analysis Software
          Descriptive Statistics
          Kruskal-Wallis Test
          Confidence Intervals
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: BACKGROUND: Patients requiring mechanical ventilation due to COVID-19 have different characteristics of evolution and outcome compared to the general ICU population. Although early weaning from mechanical ventilation is associated with improved outcomes, inadequate identification of patients unable to be weaned may lead to extubation failure and increased days on mechanical ventilation. Outcomes related to mechanical ventilation weaning in this population are scare and inconclusive. Therefore, the objective of this study was to describe the characteristics of mechanical ventilation weaning in subjects with acute respiratory failure induced by COVID-19. METHODS: This was a multi-center, prospective cohort study. We included adult subjects requiring at least 12 h of mechanical ventilation due to COVID-19 infection admitted to any participating ICUs. Characteristics of the mechanical ventilation weaning and extubation process, as well as clinical results, were the primary outcome variables. Weaning types were defined according to previously described and internationally recognized categories. RESULTS: Three hundred twenty-six subjects from 8 ICUs were included. A spontaneous breathing trial (SBT) was not performed in 52.1% of subjects. One hundred twenty-eight subjects were extubated, and 29.7% required re-intubation. All the subjects included could be classified by Weaning according to a New Definition (WIND) classification (group 0 = 52.1%, group 1 = 28.5%, group 2 = 8.0%, and group 3 = 11.3%) with statistically significant differences in duration of mechanical ventilation (P < .001) and ICU length of stay (P < .001) between groups. CONCLUSIONS: The mechanical ventilation weaning process in subjects with COVID-19 was negatively affected by the disease, with many subjects never completing an SBT. Even though temporal variables were modified, the clinical outcomes in each weaning group were similar to those previously reported.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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