Characteristics and outcomes of patients infected with nCoV19 requiring invasive mechanical ventilation in Argentina

Abstract

Objective A novel coronavirus emerged this year as a cause of viral pneumonia. The main characteristics of the virus are rapid transmission, high contagion capacity and potential severity. The objective of this case series study is to describe the clinical characteristics of patients with confirmed coronavirus disease (COVID-19) admitted to different intensive care units in Argentina for mechanical ventilation. Methods A descriptive, prospective, multicenter case series study was conducted between April 1 and May 8, 2020. Data from patients older than 18 years who were admitted to the intensive care unit for mechanical ventilation for acute respiratory failure with a positive diagnosis of COVID-19 were included. Results The variables for 47 patients from 31 intensive care units were recorded: 78.7% were men (median age of 61 years), with a SAPS II score of 43 and a Charlson index score of 3. The initial ventilatory mode was volume control - continuous mandatory ventilation with a tidal volume less than 8mL/kg in 100% of cases, with a median positive end-expiratory pressure of 10.5cmH 2 O. At the end of the study, 29 patients died, 8 were discharged, and 10 remained hospitalized. The SAPS II score was higher among patients who died (p = 0.046). Charlson comorbidity index was associated with higher mortality (OR = 2.27, 95% CI 1.13 - 4.55, p = 0.02). Conclusion Patients with COVID-19 and on mechanical ventilation in this series presented clinical variables similar to those described to date in other international reports. Our findings provide data that may predict outcomes.

Ventilación mecánica invasiva en pacientes con infección por coronavirus 2019

“…De igual manera, Lentz et al (2020) recomiendan el uso del modo asistido-controlado por volumen para iniciar el manejo del soporte ventilatorio invasivo. Plotnikow et al (2020) en una serie de reporte de casos realizada en territorio latinoamericano también refiere el uso del modo volumen control-mandatorio para el manejo de los pacientes con ARDS por COVID-19 en UCI. De tal manera, se puede evidenciar que el modo controlado por volumen es de uso mayoritario a lo largo del mundo durante la pandemia.…”

Frecuencia de debilidad adquirida en unidad de cuidados intensivos en pacientes sobrevivientes al SARS-CoV-2 que requirieron ventilación mecánica

“…En línea con nuestros hallazgos, y a diferencia de lo descripto en relación a tiempos de VM para la población general de Argentina 19 , durante la pandemia se han reportado informes en nuestro país de pacientes con SARS-CoV-2 ingresados a la UCI con tiempos significativamente mayores de soporte ventilatorio. La DAUCI, podría ser no solo la explicación para esto, sino también la que justifique la estancia prolongada en UCI e internación general en aquellos que sobreviven a la VM 3,20,21 . Además, se pudo ver que la relación negativa e inversamente proporcional de la DAUCI con la prolongación de los días de VM y días de internación es similar a la que comentan estudios locales realizados en pacientes sin SARS-CoV-2 9,12,21 , aunque debemos destacar también que en nuestros pacientes se vio un incremento notable de la frecuencia de DAUCI con respecto a los reportados previo a la pandemia.…”

Clinical characteristics and mortality in mechanically ventilated COVID-19 patients: prospective cohort study

“…Few epidemiological studies have examined the application of mechanical ventilation in the Latin American population or the management strategies used in patients diagnosed with COVID-19 (8,9). However, multicenter studies have been conducted by specialized research groups in other areas of the world (10)(11)(12)(13)(14).…”