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Intubation timing as determinant of outcome in patients with acute respiratory distress syndrome by SARS-CoV-2 infection.
Vera, Magdalena; Kattan, Eduardo; Born, Pablo; Rivas, Elizabeth; Amthauer, Macarena; Nesvadba, Annael; Lara, Barbara; Rao, Isabel; Espíndola, Eduardo; Rojas, Luis; Hernández, Glenn; Bugedo, Guillermo; Castro, Ricardo.
Afiliación
  • Vera M; Departamento de Medicina Intensiva, Pontificia Universidad Católica de Chile, Chile.
  • Kattan E; Departamento de Medicina Intensiva, Pontificia Universidad Católica de Chile, Chile.
  • Born P; Departamento de Medicina Intensiva, Pontificia Universidad Católica de Chile, Chile.
  • Rivas E; Departamento de Medicina Intensiva, Pontificia Universidad Católica de Chile, Chile.
  • Amthauer M; Departamento de Medicina Intensiva, Pontificia Universidad Católica de Chile, Chile.
  • Nesvadba A; Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile.
  • Lara B; Sección Medicina de Urgencia, Departamento de Medicina Interna, Pontificia Universidad Católica de Chile, Chile.
  • Rao I; Sección Medicina de Urgencia, Departamento de Medicina Interna, Pontificia Universidad Católica de Chile, Chile.
  • Espíndola E; Departamento de Medicina Intensiva, Pontificia Universidad Católica de Chile, Chile.
  • Rojas L; Departamento de Medicina Interna, Pontificia Universidad Católica de Chile, Chile.
  • Hernández G; Departamento de Medicina Intensiva, Pontificia Universidad Católica de Chile, Chile.
  • Bugedo G; Departamento de Medicina Intensiva, Pontificia Universidad Católica de Chile, Chile.
  • Castro R; Departamento de Medicina Intensiva, Pontificia Universidad Católica de Chile, Chile. Electronic address: rcastro@ucchristus.cl.
J Crit Care ; 65: 164-169, 2021 10.
Article en En | MEDLINE | ID: mdl-34166852
PURPOSE: To determine whether time-to-intubation was associated with higher ICU mortality in patients with COVID-19 on mechanical ventilation due to respiratory insufficiency. MATERIALS AND METHODS: We conducted an observational, prospective, single-center study of patients with confirmed SARS-CoV-2 infection hospitalized with moderate to severe ARDS, connected to mechanical ventilation in the ICU between March 17 and July 31, 2020. We examined their general and clinical characteristics. Time-to-intubation was the time from hospital admission to endotracheal intubation. RESULTS: We included 183 consecutive patients; 28% were female, and median age was 62 years old. Eighty-eight patients (48%) were intubated before 48 h (early) and ninety-five (52%) after 48 h (late). Patients intubated early had similar admission PaO2/FiO2 ratio (123 vs 99; p = 0.179) but were younger (59 vs 64; p = 0.013) and had higher body mass index (30 vs 28; p = 0.006) compared to patients intubated late. Mortality was higher in patients intubated late (18% versus 43%), with admission PaO2/FiO2 ratio < 100 mmHg (OR 5.2; p = 0.011), of older age (OR 1.1; p = 0.001), and with previous use of ACE inhibitors (OR 4.8; p = 0.026). CONCLUSIONS: In COVID-19 patients, late intubation, Pafi <100, older age, and previous ACE inhibitors use were associated with increased ICU mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Dificultad Respiratoria / COVID-19 Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Middle aged Idioma: En Revista: J Crit Care Asunto de la revista: TERAPIA INTENSIVA Año: 2021 Tipo del documento: Article País de afiliación: Chile Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Dificultad Respiratoria / COVID-19 Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Middle aged Idioma: En Revista: J Crit Care Asunto de la revista: TERAPIA INTENSIVA Año: 2021 Tipo del documento: Article País de afiliación: Chile Pais de publicación: Estados Unidos