Noninvasive ventilation in COVID-19 patients aged ≥ 70 years—a prospective multicentre cohort study
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Polok, Kamil | Fronczek, Jakub | Artigas, Antonio | Flaatten, Hans | Guidet, Bertrand | de Lange, Dylan | Fjølner, Jesper | Leaver, Susannah | Beil, Michael | Sviri, Sigal | Bruno, Raphael Romano | Wernly, Bernhard | Bollen Pinto, Bernardo | Schefold, Joerg | Studzińska, Dorota | Joannidis, Michael | Oeyen, Sandra | Marsh, Brian | Andersen, Finn | Moreno, Rui | Cecconi, Maurizio | Jung, Christian | Szczeklik, Wojciech | Eller, Philipp | Mesotten, Dieter | Reper, Pascal | Swinnen, Walter | Brix, Helene | Brushoej, Jens | Villefrance, Maja | Nedergaard, Helene Korvenius | Bjerregaard, Anders Thais | Balleby, Ida Riise | Andersen, Kasper | Hansen, Maria Aagaard | Uhrenholt, Stine | Bundgaard, Helle | Hussein, Aliae | Salah, Rehab | Ali, Yasmin Khairy Nasreldin Mohamed | Wassim, Kyrillos | Elgazzar, Yumna | Tharwat, Samar | Azzam, Ahmed | Habib, Ayman Abdelmawgoad | Abosheaishaa, Hazem Maarouf | Azab, Mohammed | Galbois, Arnaud | Charron, Cyril | Guerot, Emmanuel | Besch, Guillaume | Rigaud, Jean-Philippe | Maizel, Julien | Djibré, Michel | Burtin, Philippe | Garcon, Pierre | Nseir, Saad | Valette, Xavier | Alexandru, Nica | Marin, Nathalie | Vaissiere, Marie | Plantefeve, Gaëtan | Vanderlinden, Thierry | Jurcisin, Igor | Megarbane, Buno | Caillard, Anais | Valent, Arnaud | Garnier, Marc | Besset, Sebastien | Oziel, Johanna | Raphalen, Jean-Herlé | Dauger, Stéphane | Dumas, Guillaume | Goncalves, Bruno | Piton, Gaël | Barth, Eberhard | Goebel, Ulrich | Kunstein, Anselm | Schuster, Michael | Welte, Martin | Lutz, Matthias | Meybohm, Patrick | Steiner, Stephan | Poerner, Tudor | Haake, Hendrik | Schaller, Stefan | Kindgen-Milles, Detlef | Meyer, Christian | Kurt, Muhammed | Kuhn, Karl Friedrich | Randerath, Winfried | Wollborn, Jakob | Dindane, Zouhir | Kabitz, Hans-Joachim | Voigt, Ingo | Shala, Gonxhe | Faltlhauser, Andreas | Rovina, Nikoletta | Aidoni, Zoi | Chrisanthopoulou, Evangelia | Papadogoulas, Antonios | Gurjar, Mohan | Mahmoodpoor, Ata | Ahmed, Abdullah Khudhur | Elsaka, Ahmed | Comellini, Vittoria | Rabha, Ahmed | Ahmed, Hazem | Namendys-Silva, Silvio | Ghannam, Abdelilah | Groenendijk, Martijn | Zegers, Marieke | Cornet, Alex | Evers, Mirjam | Haas, Lenneke | Dormans, Tom | Dieperink, Willem | Romundstad, Luis | Sjøbø, Britt | Strietzel, Hans Frank | Olasveengen, Theresa | Hahn, Michael | Czuczwar, Miroslaw | Gawda, Ryszard | Klimkiewicz, Jakub | de Lurdes Campos Santos, Maria | Gordinho, André | Santos, Henrique | Assis, Rui | Oliveira, Ana Isabel Pinho | Badawy, Mohamed Raafat | Perez-Torres, David | Gomà, Gemma | Villamayor, Mercedes Ibarz | Mira, Angela Prado | Cubero, Patricia Jimeno | Rivera, Susana Arias | Tomasa, Teresa | Iglesias, David | Vázquez, Eric Mayor | Aldecoa, Cesar | Ferreira, Aida Fernández | Zalba-Etayo, Begoña | Canas-Perez, Isabel | Tamayo-Lomas, Luis | Diaz-Rodriguez, Cristina | Sancho, Susana | Priego, Jesús | Abualqumboz, Enas | Hilles, Momin Majed Yousuf | Saleh, Mahmoud | Ben-Hamouda, Nawfel | Roberti, Andrea | Dullenkopf, Alexander | Fleury, Yvan | Al-Sadawi, Mohammed
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CCSD ; BioMed Central -
International audience.
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 .
