Noninvasive ventilation in COVID-19 patients aged ≥ 70 years—a prospective multicentre cohort study Journal Articles uri icon

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abstract

  • Abstract Background Noninvasive ventilation (NIV) is a promising alternative to invasive mechanical ventilation (IMV) with a particular importance amidst the shortage of intensive care unit (ICU) beds during the COVID-19 pandemic. We aimed to evaluate the use of NIV in Europe and factors associated with outcomes of patients treated with NIV. Methods This is a substudy of COVIP study—an international prospective observational study enrolling patients aged ≥ 70 years with confirmed COVID-19 treated in ICU. We enrolled patients in 156 ICUs across 15 European countries between March 2020 and April 2021.The primary endpoint was 30-day mortality. Results Cohort included 3074 patients, most of whom were male (2197/3074, 71.4%) at the mean age of 75.7 years (SD 4.6). NIV frequency was 25.7% and varied from 1.1 to 62.0% between participating countries. Primary NIV failure, defined as need for endotracheal intubation or death within 30 days since ICU admission, occurred in 470/629 (74.7%) of patients. Factors associated with increased NIV failure risk were higher Sequential Organ Failure Assessment (SOFA) score (OR 3.73, 95% CI 2.36–5.90) and Clinical Frailty Scale (CFS) on admission (OR 1.46, 95% CI 1.06–2.00). Patients initially treated with NIV (n = 630) lived for 1.36 fewer days (95% CI − 2.27 to − 0.46 days) compared to primary IMV group (n = 1876). Conclusions Frequency of NIV use varies across European countries. Higher severity of illness and more severe frailty were associated with a risk of NIV failure among critically ill older adults with COVID-19. Primary IMV was associated with better outcomes than primary NIV. Clinical Trial RegistrationNCT04321265, registered 19 March 2020, https://clinicaltrials.gov.

authors

  • Polok, Kamil
  • Fronczek, Jakub
  • Artigas, Antonio
  • Flaatten, Hans
  • Guidet, Bertrand
  • De Lange, Dylan W
  • Fjølner, Jesper
  • Leaver, Susannah
  • Beil, Michael
  • Sviri, Sigal
  • Bruno, Raphael Romano
  • Wernly, Bernhard
  • Bollen Pinto, Bernardo
  • Schefold, Joerg C
  • Studzińska, Dorota
  • Joannidis, Michael
  • Oeyen, Sandra
  • Marsh, Brian
  • Andersen, Finn H
  • Moreno, Rui
  • Cecconi, Maurizio
  • Jung, Christian
  • Szczeklik, Wojciech
  • Eller, Philipp
  • Joannidis, Michael
  • Mesotten, Dieter
  • Reper, Pascal
  • Oeyen, Sandra
  • Swinnen, Walter
  • Brix, Helene
  • Brushoej, Jens
  • Villefrance, Maja
  • Nedergaard, Helene Korvenius
  • Bjerregaard, Anders Thais
  • Balleby, Ida Riise
  • Andersen, Kasper
  • Hansen, Maria Aagaard
  • Uhrenholt, Stine
  • Bundgaard, Helle
  • Fjølner, Jesper
  • Hussein, Aliae AR Mohamed
  • Salah, Rehab
  • Ali, Yasmin Khairy NasrEldin Mohamed
  • Wassim, Kyrillos
  • Elgazzar, Yumna A
  • Tharwat, Samar
  • Azzam, Ahmed Y
  • habib, Ayman abdelmawgoad
  • Abosheaishaa, Hazem Maarouf
  • Azab, Mohammed A
  • Leaver, Susannah
  • Galbois, Arnaud
  • Guidet, Bertrand
  • Charron, Cyril
  • Guerot, Emmanuel
  • Besch, Guillaume
  • Rigaud, Jean-Philippe
  • Maizel, Julien
  • Djibré, Michel
  • Burtin, Philippe
  • Garcon, Pierre
  • Nseir, Saad
  • Valette, Xavier
  • Alexandru, Nica
  • Marin, Nathalie
  • Vaissiere, Marie
  • Plantefeve, Gaëtan
  • Vanderlinden, Thierry
  • Jurcisin, Igor
  • Megarbane, Buno
  • Caillard, Anais
  • Valent, Arnaud
  • Garnier, Marc
  • Besset, Sebastien
  • Oziel, Johanna
  • RAPHALEN, Jean-herlé
  • Dauger, Stéphane
  • Dumas, Guillaume
  • Goncalves, Bruno
  • Piton, Gaël
  • Barth, Eberhard
  • Goebel, Ulrich
  • Barth, Eberhard
  • Kunstein, Anselm
  • Schuster, Michael
  • Welte, Martin
  • Lutz, Matthias
  • Meybohm, Patrick
  • Steiner, Stephan
  • Poerner, Tudor
  • Haake, Hendrik
  • Schaller, Stefan
  • Schaller, Stefan
  • Schaller, Stefan
  • Kindgen-Milles, Detlef
  • Meyer, Christian
  • Kurt, Muhammed
  • Kuhn, Karl Friedrich
  • Randerath, Winfried
  • Wollborn, Jakob
  • Dindane, Zouhir
  • Kabitz, Hans-Joachim
  • Voigt, Ingo
  • Shala, Gonxhe
  • Faltlhauser, Andreas
  • Rovina, Nikoletta
  • Aidoni, Zoi
  • Chrisanthopoulou, Evangelia
  • Papadogoulas, Antonios
  • Gurjar, Mohan
  • Mahmoodpoor, Ata
  • Ahmed, Abdullah khudhur
  • Marsh, Brian
  • Elsaka, Ahmed
  • Sviri, Sigal
  • Comellini, Vittoria
  • Rabha, Ahmed
  • Ahmed, Hazem
  • Namendys-Silva, Silvio A
  • Ghannam, Abdelilah
  • Groenendijk, Martijn
  • Zegers, Marieke
  • de Lange, Dylan
  • Cornet, Alex
  • Evers, Mirjam
  • Haas, Lenneke
  • Dormans, Tom
  • Dieperink, Willem
  • Romundstad, Luis
  • Sjøbø, Britt
  • Andersen, Finn H
  • Strietzel, Hans Frank
  • Olasveengen, Theresa
  • Hahn, Michael
  • Czuczwar, Miroslaw
  • Gawda, Ryszard
  • Klimkiewicz, Jakub
  • de Lurdes Campos Santos, Maria
  • Gordinho, André
  • Santos, Henrique
  • Assis, Rui
  • Oliveira, Ana Isabel Pinho
  • Badawy, Mohamed Raafat
  • Perez-Torres, David
  • Gomà, Gemma
  • Villamayor, Mercedes Ibarz
  • Mira, Angela Prado
  • Cubero, Patricia Jimeno
  • Rivera, Susana Arias
  • Tomasa, Teresa
  • Iglesias, David
  • Vázquez, Eric Mayor
  • Aldecoa, Cesar
  • Ferreira, Aida Fernández
  • Zalba-Etayo, Begoña
  • Canas-Perez, Isabel
  • Tamayo-Lomas, Luis
  • Diaz-Rodriguez, Cristina
  • Sancho, Susana
  • Priego, Jesús
  • Abualqumboz, Enas MY
  • Hilles, Momin Majed Yousuf
  • Saleh, Mahmoud
  • Ben-HAmouda, Nawfel
  • Roberti, Andrea
  • Dullenkopf, Alexander
  • Fleury, Yvan
  • Bollen Pinto, Bernardo
  • Schefold, Joerg C
  • Al-Sadawi, Mohammed

publication date

  • July 22, 2022