The Impact of Different Ventilatory Strategies on Clinical Outcomes in Patients with COVID-19 Pneumonia

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dc.contributor.authorRocans, Rihards P
dc.contributor.authorOzoliņa, Agnese
dc.contributor.authorBattaglini, Denise
dc.contributor.authorBine, Evita
dc.contributor.authorBirnbaums, Janis V
dc.contributor.authorTsarevskaya, Anastasija
dc.contributor.authorUdre, Sintija
dc.contributor.authorAleksejeva, Marija
dc.contributor.authorMamaja, Biruta
dc.contributor.authorPelosi, Paolo
dc.contributor.institutionDepartment of Anaesthesiology, Intensive Care and Clinical simulations
dc.date.accessioned2022-08-16T21:04:13Z
dc.date.available2022-08-16T21:04:13Z
dc.date.issued2022-05-11
dc.descriptionFunding Information: The authors declare that the article publication fee has been covered with the support of Educational Centre of Riga East University Hospital. No funders were involved in the study design, collection, analysis, interpretation of data or writing of this article. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
dc.description.abstractIntroduction: The aim was to investigate the impact of different ventilator strategies (non-invasive ventilation (NIV); invasive MV with tracheal tube (TT) and with tracheostomy (TS) on outcomes (mortality and intensive care unit (ICU) length of stay) in patients with COVID-19. We also assessed the impact of timing of percutaneous tracheostomy and other risk factors on mortality. Methods: The retrospective cohort included 868 patients with severe COVID-19. Demographics, MV parameters and duration, and ICU mortality were collected. Results: MV was provided in 530 (61.1%) patients, divided into three groups: NIV (n = 139), TT (n = 313), and TS (n = 78). Prevalence of tracheostomy was 14.7%, and ICU mortality was 90.4%, 60.2%, and 30.2% in TT, TS, and NIV groups, respectively (p < 0.001). Tracheostomy increased the chances of survival and being discharged from ICU (OR 6.3, p < 0.001) despite prolonging ICU stay compared to the TT group (22.2 days vs. 10.7 days, p < 0.001) without differences in survival rates between early and late tracheostomy. Patients who only received invasive MV had higher odds of survival compared to those receiving NIV in ICU prior to invasive MV (OR 2.7, p = 0.001). The odds of death increased with age (OR 1.032, p < 0.001), obesity (1.58, p = 0.041), chronic renal disease (1.57, p = 0.019), sepsis (2.8, p < 0.001), acute kidney injury (1.7, p = 0.049), multiple organ dysfunction (3.2, p < 0.001), and ARDS (3.3, p < 0.001). Conclusions: Percutaneous tracheostomy compared to MV via TT significantly increased survival and the rate of discharge from ICU, without differences between early or late tracheostomy.en
dc.description.statusPeer reviewed
dc.format.extent12
dc.format.extent695447
dc.identifier.citationRocans, R P, Ozoliņa, A, Battaglini, D, Bine, E, Birnbaums, J V, Tsarevskaya, A, Udre, S, Aleksejeva, M, Mamaja, B & Pelosi, P 2022, 'The Impact of Different Ventilatory Strategies on Clinical Outcomes in Patients with COVID-19 Pneumonia', Journal of clinical medicine, vol. 11, no. 10, 2710. https://doi.org/10.3390/jcm11102710
dc.identifier.doi10.3390/jcm11102710
dc.identifier.issn2077-0383
dc.identifier.otherPubMedCentral: PMC9143826
dc.identifier.otherunpaywall: 10.3390/jcm11102710
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/9472
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85129751010&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofJournal of clinical medicine
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectPercutaneous tracheostomy, Tracheostomy, COVID-19, Intensive care
dc.subjectCovicd-19
dc.subjectintensive care
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectGeneral Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titleThe Impact of Different Ventilatory Strategies on Clinical Outcomes in Patients with COVID-19 Pneumoniaen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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