Factors influencing liberation from mechanical ventilation in coronavirus disease 2019: multicenter observational study
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(2020) 8:80
RESEARCH
Open Access
Factors influencing liberation from mechanical ventilation in coronavirus disease 2019: multicenter observational study in fifteen Italian ICUs Lorenzo Gamberini1, Tommaso Tonetti2* , Savino Spadaro3, Gianluca Zani4, Carlo Alberto Mazzoli1, Chiara Capozzi5, Emanuela Giampalma6, Maria Letizia Bacchi Reggiani7, Elisabetta Bertellini8, Andrea Castelli5, Irene Cavalli2, Davide Colombo9,10, Federico Crimaldi11, Federica Damiani12, Alberto Fogagnolo3, Maurizio Fusari4, Emiliano Gamberini13, Giovanni Gordini1, Cristiana Laici14, Maria Concetta Lanza15, Mirco Leo16, Andrea Marudi8, Giuseppe Nardi17, Irene Ottaviani3, Raffaella Papa18, Antonella Potalivo17, Emanuele Russo13, Stefania Taddei19, Carlo Alberto Volta3, V. Marco Ranieri2 and the ICU-RER COVID-19 Collaboration
Abstract Background: A large proportion of patients with coronavirus disease 2019 (COVID-19) develop severe respiratory failure requiring admission to the intensive care unit (ICU) and about 80% of them need mechanical ventilation (MV). These patients show great complexity due to multiple organ involvement and a dynamic evolution over time; moreover, few information is available about the risk factors that may contribute to increase the time course of mechanical ventilation. The primary objective of this study is to investigate the risk factors associated with the inability to liberate COVID-19 patients from mechanical ventilation. Due to the complex evolution of the disease, we analyzed both pulmonary variables and occurrence of non-pulmonary complications during mechanical ventilation. The secondary objective of this study was the evaluation of risk factors for ICU mortality. Methods: This multicenter prospective observational study enrolled 391 patients from fifteen COVID-19 dedicated Italian ICUs which underwent invasive mechanical ventilation for COVID-19 pneumonia. Clinical and laboratory data, ventilator parameters, occurrence of organ dysfunction, and outcome were recorded. The primary outcome measure was 28 days ventilator-free days and the liberation from MV at 28 days was studied by performing a competing risks regression model on data, according to the method of Fine and Gray; the event death was considered as a competing risk. (Continued on next page)
* Correspondence: [email protected] 2 Alma Mater Studiorum, Dipartimento di Scienze Mediche e Chirurgiche, Anesthesia and Intensive Care Medicine, Policlinico di Sant’Orsola, Università di Bologna, Bologna, Italy Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative C
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