Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study
Abstract In patients intubated for hypoxemic acute respiratory failure (ARF) related to novel coronavirus disease (COVID-19), we retrospectively compared two weaning strategies, early extubation with immediate non-invasive ventilation (NIV) versus standard weaning encompassing spontaneous breathing...
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2021-06-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-92960-z |
| _version_ | 1819042269815111680 |
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| author | Gianmaria Cammarota Rosanna Vaschetto Danila Azzolina Nello De Vita Carlo Olivieri Chiara Ronco Federico Longhini Andrea Bruni Davide Colombo Claudio Pissaia Federico Prato Carlo Maestrone Matteo Maestrone Luigi Vetrugno Tiziana Bove Francesco Lemut Elisa Taretto Alessandro Locatelli Nicoletta Barzaghi Martina Cerrano Enrico Ravera Christian Zanza Andrea Della Selva Ilaria Blangetti Francesco Salvo Fabrizio Racca Yaroslava Longhitano Annalisa Boscolo Ilaria Sguazzotti Valeria Bonato Francesca Grossi Federico Crimaldi Raffaella Perucca Ester Boniolo Federico Verdina Gian Luca Vignazia Erminio Santangelo Riccardo Tarquini Marta Zanoni Antonio Messina Matteo Marin Paola Bacigalupo Graziana Sileci Nicolò Sella Edardo De Robertis Francesco Della Corte Paolo Navalesi |
| author_facet | Gianmaria Cammarota Rosanna Vaschetto Danila Azzolina Nello De Vita Carlo Olivieri Chiara Ronco Federico Longhini Andrea Bruni Davide Colombo Claudio Pissaia Federico Prato Carlo Maestrone Matteo Maestrone Luigi Vetrugno Tiziana Bove Francesco Lemut Elisa Taretto Alessandro Locatelli Nicoletta Barzaghi Martina Cerrano Enrico Ravera Christian Zanza Andrea Della Selva Ilaria Blangetti Francesco Salvo Fabrizio Racca Yaroslava Longhitano Annalisa Boscolo Ilaria Sguazzotti Valeria Bonato Francesca Grossi Federico Crimaldi Raffaella Perucca Ester Boniolo Federico Verdina Gian Luca Vignazia Erminio Santangelo Riccardo Tarquini Marta Zanoni Antonio Messina Matteo Marin Paola Bacigalupo Graziana Sileci Nicolò Sella Edardo De Robertis Francesco Della Corte Paolo Navalesi |
| author_sort | Gianmaria Cammarota |
| collection | DOAJ |
| description | Abstract In patients intubated for hypoxemic acute respiratory failure (ARF) related to novel coronavirus disease (COVID-19), we retrospectively compared two weaning strategies, early extubation with immediate non-invasive ventilation (NIV) versus standard weaning encompassing spontaneous breathing trial (SBT), with respect to IMV duration (primary endpoint), extubation failures and reintubations, rate of tracheostomy, intensive care unit (ICU) length of stay and mortality (additional endpoints). All COVID-19 adult patients, intubated for hypoxemic ARF and subsequently extubated, were enrolled. Patients were included in two groups, early extubation followed by immediate NIV application, and conventionally weaning after passing SBT. 121 patients were enrolled and analyzed, 66 early extubated and 55 conventionally weaned after passing an SBT. IMV duration was 9 [6–11] days in early extubated patients versus 11 [6–15] days in standard weaning group (p = 0.034). Extubation failures [12 (18.2%) vs. 25 (45.5%), p = 0.002] and reintubations [12 (18.2%) vs. 22 (40.0%) p = 0.009] were fewer in early extubation compared to the standard weaning groups, respectively. Rate of tracheostomy, ICU mortality, and ICU length of stay were no different between groups. Compared to standard weaning, early extubation followed by immediate NIV shortened IMV duration and reduced the rate of extubation failure and reintubation. |
| first_indexed | 2024-12-21T09:38:13Z |
| format | Article |
| id | doaj.art-f52f0ee4ddb841aca78990eefd039688 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-21T09:38:13Z |
| publishDate | 2021-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-f52f0ee4ddb841aca78990eefd0396882022-12-21T19:08:34ZengNature PortfolioScientific Reports2045-23222021-06-011111910.1038/s41598-021-92960-zEarly extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter studyGianmaria Cammarota0Rosanna Vaschetto1Danila Azzolina2Nello De Vita3Carlo Olivieri4Chiara Ronco5Federico Longhini6Andrea Bruni7Davide Colombo8Claudio Pissaia9Federico Prato10Carlo Maestrone11Matteo Maestrone12Luigi Vetrugno13Tiziana Bove14Francesco Lemut15Elisa Taretto16Alessandro Locatelli17Nicoletta Barzaghi18Martina Cerrano19Enrico Ravera20Christian Zanza21Andrea Della Selva22Ilaria Blangetti23Francesco Salvo24Fabrizio Racca25Yaroslava Longhitano26Annalisa Boscolo27Ilaria Sguazzotti28Valeria Bonato29Francesca Grossi30Federico Crimaldi31Raffaella Perucca32Ester Boniolo33Federico Verdina34Gian Luca Vignazia35Erminio Santangelo36Riccardo Tarquini37Marta Zanoni38Antonio Messina39Matteo Marin40Paola Bacigalupo41Graziana Sileci42Nicolò Sella43Edardo De Robertis44Francesco Della Corte45Paolo Navalesi46Dipartimento di Medicina e Chirurgia, Università degli Studi di PerugiaDepartment of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”Translational Medicine Department, Università “del Piemonte Orientale”Translational Medicine Department, Università “del Piemonte Orientale”Anesthesia and Intensive Care, Ospedale Sant’Andrea”Anesthesia and Intensive Care, Ospedale Sant’Andrea”Department of Medical and Surgical Science, Università “Magna Graecia”Department of Medical and Surgical Science, Università “Magna Graecia”Department of Anesthesia and Critical Care, Ospedale “Ss. Trinità”Department of Anesthesia and Critical Care, Ospedale “degli Infermi”Department of Anesthesia and Critical Care, Ospedale “degli Infermi”Department of Anesthesia and Critical Care, Presidio Ospedaliero Domodossola e Verbania “ASL VCO”Department of Anesthesia and Critical Care, Presidio Ospedaliero Domodossola e Verbania “ASL VCO”Department of Medicine, Anesthesia and Intensive Care Clinic, Università di UdineDepartment of Medicine, Anesthesia and Intensive Care Clinic, Università di UdineDepartment of Anesthesia and Critical Care, Ospedale “Monsignor Giovanni Galliano”Department of Anesthesia and Critical Care, Ospedale “Monsignor Giovanni Galliano”Department of Anesthesia and Critical Care, Azienda Ospedaliera “Santa Croce e Carle”Department of Anesthesia and Critical Care, Azienda Ospedaliera “Santa Croce e Carle”Department of Anesthesia and Critical Care, Azienda Ospedaliera “Santa Croce e Carle”Department of Emergency Medicine-Anesthesia and Critical Care-Michele, Pietro Ferrero HospitalDepartment of Emergency Medicine-Anesthesia and Critical Care-Michele, Pietro Ferrero HospitalDepartment of Emergency Medicine-Anesthesia and Critical Care-Michele, Pietro Ferrero HospitalDepartment of Anesthesia and Intensive Care, Ospedale “Regina Montis Regalis”Department of Anesthesia and Intensive Care, Ospedale “Regina Montis Regalis”Department of Anesthesia and Intensive Care, Azienda Ospedaliera SS. Antonio e Biagio e Cesare ArrigoDepartment of Anesthesia and Intensive Care, Azienda Ospedaliera SS. Antonio e Biagio e Cesare ArrigoAnesthesia and Intensive Care Unit, Ospedale Universitario di PadovaDepartment of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”Department of Anesthesia and Intensive Care, Azienda Ospedaliera SS. Antonio e Biagio e Cesare ArrigoDepartment of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”Translational Medicine Department, Università “del Piemonte Orientale”Department of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”Translational Medicine Department, Università “del Piemonte Orientale”Translational Medicine Department, Università “del Piemonte Orientale”Department of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”Translational Medicine Department, Università “del Piemonte Orientale”Translational Medicine Department, Università “del Piemonte Orientale”Department of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”Humanitas, Clinical and Research Center – IRCCSDepartment of Medicine, Anesthesia and Intensive Care Clinic, Università di UdineDepartment of Anesthesia and Critical Care, Ospedale “Monsignor Giovanni Galliano”Department of Anesthesia and Critical Care, Ospedale “Monsignor Giovanni Galliano”Department of Medicine-DIMED, Università di PadovaDipartimento di Medicina e Chirurgia, Università degli Studi di PerugiaDepartment of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”Anesthesia and Intensive Care Unit, Ospedale Universitario di PadovaAbstract In patients intubated for hypoxemic acute respiratory failure (ARF) related to novel coronavirus disease (COVID-19), we retrospectively compared two weaning strategies, early extubation with immediate non-invasive ventilation (NIV) versus standard weaning encompassing spontaneous breathing trial (SBT), with respect to IMV duration (primary endpoint), extubation failures and reintubations, rate of tracheostomy, intensive care unit (ICU) length of stay and mortality (additional endpoints). All COVID-19 adult patients, intubated for hypoxemic ARF and subsequently extubated, were enrolled. Patients were included in two groups, early extubation followed by immediate NIV application, and conventionally weaning after passing SBT. 121 patients were enrolled and analyzed, 66 early extubated and 55 conventionally weaned after passing an SBT. IMV duration was 9 [6–11] days in early extubated patients versus 11 [6–15] days in standard weaning group (p = 0.034). Extubation failures [12 (18.2%) vs. 25 (45.5%), p = 0.002] and reintubations [12 (18.2%) vs. 22 (40.0%) p = 0.009] were fewer in early extubation compared to the standard weaning groups, respectively. Rate of tracheostomy, ICU mortality, and ICU length of stay were no different between groups. Compared to standard weaning, early extubation followed by immediate NIV shortened IMV duration and reduced the rate of extubation failure and reintubation.https://doi.org/10.1038/s41598-021-92960-z |
| spellingShingle | Gianmaria Cammarota Rosanna Vaschetto Danila Azzolina Nello De Vita Carlo Olivieri Chiara Ronco Federico Longhini Andrea Bruni Davide Colombo Claudio Pissaia Federico Prato Carlo Maestrone Matteo Maestrone Luigi Vetrugno Tiziana Bove Francesco Lemut Elisa Taretto Alessandro Locatelli Nicoletta Barzaghi Martina Cerrano Enrico Ravera Christian Zanza Andrea Della Selva Ilaria Blangetti Francesco Salvo Fabrizio Racca Yaroslava Longhitano Annalisa Boscolo Ilaria Sguazzotti Valeria Bonato Francesca Grossi Federico Crimaldi Raffaella Perucca Ester Boniolo Federico Verdina Gian Luca Vignazia Erminio Santangelo Riccardo Tarquini Marta Zanoni Antonio Messina Matteo Marin Paola Bacigalupo Graziana Sileci Nicolò Sella Edardo De Robertis Francesco Della Corte Paolo Navalesi Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study Scientific Reports |
| title | Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study |
| title_full | Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study |
| title_fullStr | Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study |
| title_full_unstemmed | Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study |
| title_short | Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study |
| title_sort | early extubation with immediate non invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019 a retrospective multicenter study |
| url | https://doi.org/10.1038/s41598-021-92960-z |
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