Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany. Issue 2 (March 2021)

• Record Type: Journal Article
• Authors: Roedl, Kevin; Jarczak, Dominik; Thasler, Liina; Bachmann, Martin; Schulte, Frank; Bein, Berthold; Weber, Christian Friedrich; Schäfer, Ulrich; Veit, Carsten; Hauber, Hans-Peter; Kopp, Sebastian; Sydow, Karsten; de Weerth, Andreas; Bota, Marc; Schreiber, Rüdiger; Detsch, Oliver; Rogmann, Jan-Peer; Frings, Daniel; Sensen, Barbara; Burdelski, Christoph; Boenisch, Olaf; Nierhaus, Axel; de Heer, Geraldine; Kluge, Stefan
• Is Part Of: Australian critical care. Volume 34:Issue 2(2021)
• Page Start: 167
• Page End: 175
• Publication Date: 2021-03
• Subjects: Mechanical ventilation -- COVID-19 -- SARS-CoV-2 -- ARDS -- Mortality -- Multiple organ failure; Intensive care nursing -- Periodicals; Intensive care nursing -- Australia -- Periodicals; Electronic journals; 616.028
• DOI: 10.1016/j.aucc.2020.10.009
• Languages: English
• ISSNs: 1036-7314

Abstract

Abstract: 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.