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Clinical features, ...
Clinical features, ventilatory management, and outcome of ARDS caused by COVID-19 are similar to other causes of ARDS
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- Ferrando, Carlos (författare)
- Hosp Clin Barcelona, Inst Invest August Pi & Sunyer, Dept Anesthesiol & Crit Care, Villarroel 170, Barcelona 08025, Spain.;Inst Salud Carlos III, CIBER Enfermedades Resp, Madrid, Spain.
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- Suarez-Sipmann, Fernando (författare)
- Uppsala universitet,Klinisk fysiologi,Anestesiologi och intensivvård,Hedenstiernalaboratoriet,Inst Salud Carlos III, CIBER Enfermedades Resp, Madrid, Spain.;Uppsala Univ Hosp, Dept Surg Sci, Hedenstierna Lab, Uppsala, Sweden.;Hosp Univ La Princesa, Intens Care Unit, Madrid, Spain.
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- Mellado-Artigas, Ricard (författare)
- Hosp Clin Barcelona, Inst Invest August Pi & Sunyer, Dept Anesthesiol & Crit Care, Villarroel 170, Barcelona 08025, Spain.
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- Hernandez, Maria (författare)
- Hosp Cruces, Dept Anesthesiol & Crit Care, Baracaldo, Vizcaya, Spain.
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- Gea, Alfredo (författare)
- Univ Navarra, Med Sch, Dept Prevent Med & Publ Hlth, Pamplona, Spain.
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- Arruti, Egoitz (författare)
- Ubikare Technol, Vizcaya, Spain.
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- Aldecoa, Cesar (författare)
- Hosp Univ Rio Hortega, Dept Anesthesiol & Crit Care, Valladolid, Spain.
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- Martinez-Palli, Graciela (författare)
- Hosp Clin Barcelona, Inst Invest August Pi & Sunyer, Dept Anesthesiol & Crit Care, Villarroel 170, Barcelona 08025, Spain.
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- Martinez-Gonzalez, Miguel A. (författare)
- Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA.;Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain.
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- Slutsky, Arthur S. (författare)
- St Michaels Hosp, Li Ka Shing Knowledge Inst, Toronto, ON, Canada.;Univ Toronto, Dept Med, Toronto, ON, Canada.
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- Villar, Jesus (författare)
- Inst Salud Carlos III, CIBER Enfermedades Resp, Madrid, Spain.;St Michaels Hosp, Li Ka Shing Knowledge Inst, Toronto, ON, Canada.;Hosp Univ Dr Negrin, Res Unit, Multidisciplinary Organ Dysfunct Evaluat Res Netw, Las Palmas Gran Canaria, Spain.
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Hosp Clin Barcelona, Inst Invest August Pi & Sunyer, Dept Anesthesiol & Crit Care, Villarroel 170, Barcelona 08025, Spain;Inst Salud Carlos III, CIBER Enfermedades Resp, Madrid, Spain. Klinisk fysiologi (creator_code:org_t)
- 2020-07-29
- 2020
- Engelska.
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Ingår i: Intensive Care Medicine. - : SPRINGER. - 0342-4642 .- 1432-1238. ; 46:12, s. 2200-2211
- Relaterad länk:
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https://doi.org/10.1...
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https://link.springe...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Purpose The main characteristics of mechanically ventilated ARDS patients affected with COVID-19, and the adherence to lung-protective ventilation strategies are not well known. We describe characteristics and outcomes of confirmed ARDS in COVID-19 patients managed with invasive mechanical ventilation (MV). Methods This is a multicenter, prospective, observational study in consecutive, mechanically ventilated patients with ARDS (as defined by the Berlin criteria) affected with with COVID-19 (confirmed SARS-CoV-2 infection in nasal or pharyngeal swab specimens), admitted to a network of 36 Spanish and Andorran intensive care units (ICUs) between March 12 and June 1, 2020. We examined the clinical features, ventilatory management, and clinical outcomes of COVID-19 ARDS patients, and compared some results with other relevant studies in non-COVID-19 ARDS patients. Results A total of 742 patients were analysed with complete 28-day outcome data: 128 (17.1%) with mild, 331 (44.6%) with moderate, and 283 (38.1%) with severe ARDS. At baseline, defined as the first day on invasive MV, median (IQR) values were: tidal volume 6.9 (6.3-7.8) ml/kg predicted body weight, positive end-expiratory pressure 12 (11-14) cmH(2)O. Values of respiratory system compliance 35 (27-45) ml/cmH(2)O, plateau pressure 25 (22-29) cmH(2)O, and driving pressure 12 (10-16) cmH(2)O were similar cto values from non-COVID-19 ARDS observed in other studies. Recruitment maneuvers, prone position and neuromuscular blocking agents were used in 79%, 76% and 72% of patients, respectively. The risk of 28-day mortality was lower in mild ARDS [hazard ratio (RR) 0.56 (95% CI 0.33-0.93),p = 0.026] and moderate ARDS [hazard ratio (RR) 0.69 (95% CI 0.47-0.97),p = 0.035] when compared to severe ARDS. The 28-day mortality was similar to other observational studies in non-COVID-19 ARDS patients. Conclusions In this large series, COVID-19 ARDS patients have features similar to other causes of ARDS, compliance with lung-protective ventilation was high, and the risk of 28-day mortality increased with the degree of ARDS severity.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- Acute respiratory distress syndrome
- Coronavirus
- Mechanical ventilation
- Outcome
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Ferrando, Carlos
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Suarez-Sipmann, ...
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Mellado-Artigas, ...
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Hernandez, Maria
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Gea, Alfredo
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Arruti, Egoitz
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Aldecoa, Cesar
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Martinez-Palli, ...
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Martinez-Gonzale ...
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Slutsky, Arthur ...
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Villar, Jesus
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Uppsala universitet