Ventilasjonsstøtte for hypoksemiske intensivpasienter med covid-19

Gundem, Trine; Olasveengen, Theresa M.; Hovda, Knut Erik; Gaustad, Knut; Schøndorf, Christina; Rostrup, Morten; Frøyshov, Sten; Undseth, Øystein; Tonby, Kristian; Holten, Aleksander Rygh; Sunde, Kjetil

doi:10.4045/tidsskr.20.0445

Cited by 6 publications

(6 citation statements)

References 10 publications

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“…7 Parainfluensavirus, humant metapneumovirus, adenovirus og influensa B-virus. 8 Dyp venetrombose diagnostisert ved ultralyd av underekstremiteter eller lungeembolus diagnostisert ved pulmonal CT-angiografi. 9 Lavmolekylaert heparin.…”

Section: Tabellunclassified

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70 pasienter med covid-19 innlagt ved Sykehuset Østfold

Øverstad¹,

Tjønnfjord²,

Olsen³

et al. 2020

Tidsskriftet

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Section: Tabellunclassified

“…Sykdommen ser ut til å ramme alle aldersgrupper, med økende morbiditet og mortalitet med alder (3)(4)(5). I Norge foreligger det publiserte data fra Baerum sykehus, som rapporterer om sykehusdødelighet på 19 %, og Ullevål sykehus, som rapporterer om 91 % overlevelse hos en intensivpopulasjon (6)(7)(8).…”

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70 pasienter med covid-19 innlagt ved Sykehuset Østfold

Øverstad¹,

Tjønnfjord²,

Olsen³

et al. 2020

Tidsskriftet

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“…SARS-CoV-2 causes coronavirus disease-19 (COVID-19), a multi-system illness with high morbidity and mortality related to progressive life-threatening pneumonia 3 , 4 . Patients frequently need ventilatory support due to the advanced disease severity 5 – 7 . Even though ventilatory supports are life-saving treatments, these are commonly associated with infectious and non-infectious complications 8 – 10 .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for developing ventilator-associated lower respiratory tract infection in patients with severe COVID-19: a multinational, multicentre study, prospective, observational study

Reyes

Fuentes

Duque

et al. 2023

Sci Rep

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Around one-third of patients diagnosed with COVID-19 develop a severe illness that requires admission to the Intensive Care Unit (ICU). In clinical practice, clinicians have learned that patients admitted to the ICU due to severe COVID-19 frequently develop ventilator-associated lower respiratory tract infections (VA-LRTI). This study aims to describe the clinical characteristics, the factors associated with VA-LRTI, and its impact on clinical outcomes in patients with severe COVID-19. This was a multicentre, observational cohort study conducted in ten countries in Latin America and Europe. We included patients with confirmed rtPCR for SARS-CoV-2 requiring ICU admission and endotracheal intubation. Only patients with a microbiological and clinical diagnosis of VA-LRTI were included. Multivariate Logistic regression analyses and Random Forest were conducted to determine the risk factors for VA-LRTI and its clinical impact in patients with severe COVID-19. In our study cohort of 3287 patients, VA-LRTI was diagnosed in 28.8% [948/3287]. The cumulative incidence of ventilator-associated pneumonia (VAP) was 18.6% [610/3287], followed by ventilator-associated tracheobronchitis (VAT) 10.3% [338/3287]. A total of 1252 bacteria species were isolated. The most frequently isolated pathogens were Pseudomonas aeruginosa (21.2% [266/1252]), followed by Klebsiella pneumoniae (19.1% [239/1252]) and Staphylococcus aureus (15.5% [194/1,252]). The factors independently associated with the development of VA-LRTI were prolonged stay under invasive mechanical ventilation, AKI during ICU stay, and the number of comorbidities. Regarding the clinical impact of VA-LRTI, patients with VAP had an increased risk of hospital mortality (OR [95% CI] of 1.81 [1.40–2.34]), while VAT was not associated with increased hospital mortality (OR [95% CI] of 1.34 [0.98–1.83]). VA-LRTI, often with difficult-to-treat bacteria, is frequent in patients admitted to the ICU due to severe COVID-19 and is associated with worse clinical outcomes, including higher mortality. Identifying risk factors for VA-LRTI might allow the early patient diagnosis to improve clinical outcomes.Trial registration: This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable.

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“…Derfor er det også viktig å finne ut hvordan vi best kan behandle pasienter med covid-19 og respirasjonssvikt, slik at vi ikke iverksetter invasiv behandling hos pasienter som kan klare seg med enklere tiltak. I Tidsskriftet presenterer nå Gundem og medarbeidere resultater fra behandlingen av 26 intensivpasienter med covid-19 og respirasjonssvikt ved Oslo universitetssykehus (4). Hovedfunnet er at de som fikk oksygenbehandling uten intubasjon klarte seg godt, og at dødeligheten hos alle pasienter var lav.…”

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Når er ventilasjonsstøtte nødvendig?

Brattebø¹

2020

Tidsskriftet

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Guttorm Brattebø er seksjonsoverlege ved Kirurgisk serviceklinikk, Haukeland universitetssjukehus, og professor i traumatologi ved Universitetet i Bergen. Han er også Norsk anestesiologisk forenings representant i European Board of Anaesthesiology (EBA UEMS). Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.Vi bør kanskje vaere mer tilbakeholdne med å gi invasiv ventilasjonsstøtte til covid-19pasienter med alvorlig respirasjonssvikt.

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Ventilasjonsstøtte for hypoksemiske intensivpasienter med covid-19

Cited by 6 publications

References 10 publications

70 pasienter med covid-19 innlagt ved Sykehuset Østfold

70 pasienter med covid-19 innlagt ved Sykehuset Østfold

Risk factors for developing ventilator-associated lower respiratory tract infection in patients with severe COVID-19: a multinational, multicentre study, prospective, observational study

Når er ventilasjonsstøtte nødvendig?

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