Partitioning Mechanical Ventilator Duration in COVID-19–related Acute Respiratory Distress Syndrome

Gendreau, Ségolène; Benelli, Brice; Delière, Maxime; Tuffet, Samuel; Prost, Nicolas de; Razazi, Keyvan; Carteaux, Guillaume; Dessap, Armand Mekontso

doi:10.1164/rccm.202108-1963le

Cited by 4 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our cohort, 34.5% of patients received care in the ICU, which is in accordance to published findings that nearly 1 in 3 (33%) hospitalized patients with COVID-19 develop ARDs and 1 in 4 hospitalized patients require transfer to the ICU (26%) [ 31 ]. We also know that patients with COVID-19 admitted to the ICU have longer length of stay in the hospital and ICU, longer length of mechanical ventilation, and therefore may be at increased risk of nosocomial infections [ 32 , 33 ]. If we are to extrapolate those percentages to the over 6 million people hospitalized due to COVID 19, it may be expected that over 1.5 million people may experience the elevated HCU described in our study.…”

Section: Discussionmentioning

confidence: 99%

Healthcare utilization 9 months pre- and post- COVID-19 hospitalization among patients discharged alive

Zaidan,

Puebla Neira,

Polychronopoulou

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

Background Emerging evidence suggests that there is an increase in healthcare utilization (HCU) in patients due to Coronavirus Disease 2019 (COVID-19). We investigated the change in HCU pre and post hospitalization among patients discharged home from COVID-19 hospitalization for up to 9 months of follow up. Study design and methods This retrospective study from a United States cohort used Optum® de-identified Clinformatics Data Mart; it included adults discharged home post hospitalization with primary diagnosis of COVID-19 between April 2020 and March 2021. We evaluated HCU of patients 9 months pre and post -discharge from index hospitalization. We defined HCU as emergency department (ED), inpatient, outpatient (office), rehabilitation/skilled nursing facility (SNF), telemedicine visits, and length of stay, expressed as number of visits per 10,000 person-days. Results We identified 63,161 patients discharged home after COVID-19 hospitalization. The cohort of patients was mostly white (58.8%) and women (53.7%), with mean age 72.4 (SD± 12) years. These patients were significantly more likely to have increased HCU in the 9 months post hospitalization compared to the 9 months prior. Patients had a 47%, 67%, 65%, and 51% increased risk of ED (rate ratio 1.47; 95% CI 1.45–1.49; p < .0001), rehabilitation (rate ratio 1.67; 95% CI 1.61–1.73; p < .0001), office (rate ratio1.65; 95% CI 1.64–1.65; p < .0001), and telemedicine visits (rate ratio 1.5; 95% CI 1.48–1.54; p < .0001), respectively. We also found significantly different rates of HCU for women compared to men (women have higher risk of ED, rehabilitation, and telemedicine visits but a lower risk of inpatient visits, length of stay, and office visits than men) and for patients who received care in the intensive care unit (ICU) vs those who did not (ICU patients had increased risk of ED, inpatient, office, and telemedicine visits and longer length of stay but a lower risk of rehabilitation visits). Outpatient (office) visits were the highest healthcare service utilized post discharge (64.5% increase). Finally, the risk of having an outpatient visit to any of the specialties studied significantly increased post discharge. Interestingly, the risk of requiring a visit to pulmonary medicine was the highest amongst the specialties studied (rate ratio 3.35, 95% CI 3.26–3.45, p < .0001). Conclusion HCU was higher after index hospitalization compared to 9 months prior among patients discharged home post-COVID-19 hospitalization. The increases in HCU may be driven by those patients who received care in the ICU.

show abstract

Section: Discussionmentioning

confidence: 99%

Healthcare utilization 9 months pre- and post- COVID-19 hospitalization among patients discharged alive

Zaidan,

Puebla Neira,

Polychronopoulou

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…The presence of uncontrolled immune responses in COVID-19 patients may hinder lung recovery and complicate the assessment of readiness for ventilatory weaning. 20 , 25 …”

Section: Discussionmentioning

confidence: 99%

“…A presença de respostas imunes descontroladas nos pacientes com COVID-19 pode dificultar a recuperação pulmonar e complicar a avaliação da prontidão para o desmame ventilatório. (20,25) A associação entre o acometimento pulmonar na TC de tórax e o desmame prolongado também levanta preocupações significativas. A TC de tórax foi amplamente utilizada durante a pandemia para avaliar a gravidade da COVID-19, identificar complicações e predizer a evolução da doença nos casos graves.…”

Section: Discussionunclassified

Predictors of prolonged ventilator weaning and mortality in critically ill patients with COVID-19

M Musumeci,

Valle Pinheiro2,

Dias Chiavegato1

et al. 2023

J Bras Pneumol.

View full text Add to dashboard Cite

Objective: To identify factors associated with prolonged weaning and mortality in critically ill COVID-19 patients admitted to ICUs and under invasive mechanical ventilation. Methods: Between March of 2020 and July of 2021, we retrospectively recorded clinical and ventilatory characteristics of critically ill COVID-19 patients from the day of intubation to the outcome. We classified the patients regarding the weaning period in accordance with established criteria. A logistic regression analysis was performed to identify variables associated with prolonged weaning and mortality. Results: The study involved 303 patients, 100 of whom (33.0%) had a prolonged weaning period. Most of the patients were male (69.6%), 136 (44.8%) had more than 50% of pulmonary involvement on chest CT, and 93 (30.6%) had severe ARDS. Within the prolonged weaning group, 62% died within 60 days. Multivariate analysis revealed that lung involvement greater than 50% on CT and delay from intubation to the first separation attempt from mechanical ventilation were significantly associated with prolonged weaning, whereas age and prolonged weaning were significantly associated with mortality. Conclusions: Prolonged weaning can be used as a milestone in predicting mortality in critically ill COVID-19 patients. Lung involvement greater than 50% on CT and delay from intubation to the first separation attempt from mechanical ventilation were identified as significant predictors of prolonged weaning. These results might provide valuable information for healthcare professionals when making clinical decisions regarding the management of critically ill COVID-19 patients who are on mechanical ventilation.

show abstract

Untitled

View full text Add to dashboard Cite

Partitioning Mechanical Ventilator Duration in COVID-19–related Acute Respiratory Distress Syndrome

Cited by 4 publications

References 11 publications

Healthcare utilization 9 months pre- and post- COVID-19 hospitalization among patients discharged alive

Healthcare utilization 9 months pre- and post- COVID-19 hospitalization among patients discharged alive

Predictors of prolonged ventilator weaning and mortality in critically ill patients with COVID-19

Untitled

Contact Info

Product

Resources

About