Noninvasive ventilation in COVID-19 patients aged ≥ 70 years—a prospective multicentre cohort study
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...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-07-01
|
| Series: | Critical Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13054-022-04082-1 |
| _version_ | 1811287470720942080 |
|---|---|
| author | Kamil Polok Jakub Fronczek Antonio Artigas Hans Flaatten Bertrand Guidet Dylan W. De Lange Jesper Fjølner Susannah Leaver Michael Beil Sigal Sviri Raphael Romano Bruno Bernhard Wernly Bernardo Bollen Pinto Joerg C. Schefold Dorota Studzińska Michael Joannidis Sandra Oeyen Brian Marsh Finn H. Andersen Rui Moreno Maurizio Cecconi Christian Jung Wojciech Szczeklik COVIP Study Group |
| author_facet | Kamil Polok Jakub Fronczek Antonio Artigas Hans Flaatten Bertrand Guidet Dylan W. De Lange Jesper Fjølner Susannah Leaver Michael Beil Sigal Sviri Raphael Romano Bruno Bernhard Wernly Bernardo Bollen Pinto Joerg C. Schefold Dorota Studzińska Michael Joannidis Sandra Oeyen Brian Marsh Finn H. Andersen Rui Moreno Maurizio Cecconi Christian Jung Wojciech Szczeklik COVIP Study Group |
| author_sort | Kamil Polok |
| collection | DOAJ |
| description | 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 Registration NCT04321265 , registered 19 March 2020, https://clinicaltrials.gov . |
| first_indexed | 2024-04-13T03:19:04Z |
| format | Article |
| id | doaj.art-e5622ce594874c2494d966541c56d86e |
| institution | Directory Open Access Journal |
| issn | 1364-8535 |
| language | English |
| last_indexed | 2024-04-13T03:19:04Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Critical Care |
| spelling | doaj.art-e5622ce594874c2494d966541c56d86e2022-12-22T03:04:50ZengBMCCritical Care1364-85352022-07-0126111210.1186/s13054-022-04082-1Noninvasive ventilation in COVID-19 patients aged ≥ 70 years—a prospective multicentre cohort studyKamil Polok0Jakub Fronczek1Antonio Artigas2Hans Flaatten3Bertrand Guidet4Dylan W. De Lange5Jesper Fjølner6Susannah Leaver7Michael Beil8Sigal Sviri9Raphael Romano Bruno10Bernhard Wernly11Bernardo Bollen Pinto12Joerg C. Schefold13Dorota Studzińska14Michael Joannidis15Sandra Oeyen16Brian Marsh17Finn H. Andersen18Rui Moreno19Maurizio Cecconi20Christian Jung21Wojciech Szczeklik22COVIP Study GroupCentre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical CollegeCentre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical CollegeCritical Care Department, Corporacion Sanitaria Universitaria Parc Tauli, CIBER Enfermedades Respiratorias, Autonomous University of BarcelonaDepartment of Anaesthesia and Intensive Care, Haukeland University HospitalINSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Equipe: Epidémiologie Hospitalière Qualité et Organisation des Soins, Sorbonne Universités, UPMC Univ Paris 06Department of Intensive Care Medicine, University Medical Center, University UtrechtDepartment of Anaesthesia and Intensive Care, Viborg Regional HospitalDepartment of Critical Care Medicine, St George’s HospitalMedical Intensive Care Unit, Hadassah Medical CenterDepartment of Medical Intensive Care, Hadassah Medical Center and Faculty of Medicine, Hebrew University of JerusalemDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University DuesseldorfDepartment of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical UniversityDepartment of Acute Medicine, Geneva University HospitalsDepartment of Intensive Care Medicine, Inselspital, Bern University Hospital, University of BernCentre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical CollegeDivision of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University InnsbruckDepartment of Intensive Care 1K12IC, Ghent University HospitalDepartment of Critical Care Medicine, Mater Misericordiae University HospitalDepartment of Anaesthesia and Intensive Care, Ålesund HospitalFaculdade de Ciências Médicas de Lisboa - Nova Médical School, Hospital de São José, Centro Hospitalar Universitário de Lisboa CentralDepartment of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center – IRCCSDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University DuesseldorfCentre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical CollegeAbstract 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 Registration NCT04321265 , registered 19 March 2020, https://clinicaltrials.gov .https://doi.org/10.1186/s13054-022-04082-1COVID-19Noninvasive ventilationFrailtyIntensive care unitElderly |
| spellingShingle | Kamil Polok Jakub Fronczek Antonio Artigas Hans Flaatten Bertrand Guidet Dylan W. De Lange Jesper Fjølner Susannah Leaver Michael Beil Sigal Sviri Raphael Romano Bruno Bernhard Wernly Bernardo Bollen Pinto Joerg C. Schefold Dorota Studzińska Michael Joannidis Sandra Oeyen Brian Marsh Finn H. Andersen Rui Moreno Maurizio Cecconi Christian Jung Wojciech Szczeklik COVIP Study Group Noninvasive ventilation in COVID-19 patients aged ≥ 70 years—a prospective multicentre cohort study Critical Care COVID-19 Noninvasive ventilation Frailty Intensive care unit Elderly |
| title | Noninvasive ventilation in COVID-19 patients aged ≥ 70 years—a prospective multicentre cohort study |
| title_full | Noninvasive ventilation in COVID-19 patients aged ≥ 70 years—a prospective multicentre cohort study |
| title_fullStr | Noninvasive ventilation in COVID-19 patients aged ≥ 70 years—a prospective multicentre cohort study |
| title_full_unstemmed | Noninvasive ventilation in COVID-19 patients aged ≥ 70 years—a prospective multicentre cohort study |
| title_short | Noninvasive ventilation in COVID-19 patients aged ≥ 70 years—a prospective multicentre cohort study |
| title_sort | noninvasive ventilation in covid 19 patients aged ≥ 70 years a prospective multicentre cohort study |
| topic | COVID-19 Noninvasive ventilation Frailty Intensive care unit Elderly |
| url | https://doi.org/10.1186/s13054-022-04082-1 |
| work_keys_str_mv | AT kamilpolok noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT jakubfronczek noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT antonioartigas noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT hansflaatten noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT bertrandguidet noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT dylanwdelange noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT jesperfjølner noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT susannahleaver noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT michaelbeil noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT sigalsviri noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT raphaelromanobruno noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT bernhardwernly noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT bernardobollenpinto noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT joergcschefold noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT dorotastudzinska noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT michaeljoannidis noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT sandraoeyen noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT brianmarsh noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT finnhandersen noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT ruimoreno noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT mauriziocecconi noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT christianjung noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT wojciechszczeklik noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy AT covipstudygroup noninvasiveventilationincovid19patientsaged70yearsaprospectivemulticentrecohortstudy |