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Abstract
BACKGROUND: Patients with ARDS due to coronavirus disease 2019 (COVID-19) may require tracheostomy and transfer to a weaning center. To date, data on the outcome of these patients are scarce. The objectives of this study were to determine the factors associated with time to decannulation and limb-muscle strength recovery.
METHODS: This was an observational retrospective study of subjects with COVID-19–related ARDS requiring tracheostomy after prolonged ventilation, who were subsequently transferred to a weaning center from April 4, 2020–May 30, 2020.
RESULTS: Forty-three subjects were included. Median age (interquartile range) was 61 (48–66) y; 81% were men, and median body mass index (BMI) was 30 (26–35) kg/m2. Tracheostomy was performed after a median of 19 (12–27) d of mechanical ventilation, and the median ICU length of stay prior to transfer to the weaning center was 30 (21–46) d. On admission to the weaning center, the median Medical Research Council (MRC) score was 36 (27–44). Time to decannulation was 9 (7–18) d after admission to the weaning center. The only factor independently associated with early decannulation was the MRC score on admission to the weaning center (odds ratio 1.16 [95% CI 1.06–1.31], P = .005). Two factors were independently associated with MRC gain ≥ 10: BMI (odds ratio 0.88 [95% CI 0.76–0.99], P = .045) and MRC on admission (odds ratio 0.91 [95% CI 0.82–0.98], P = .03. Three months after admission to the weaning center, 40 subjects (93%) were weaned from mechanical ventilation and 36 (84%) had returned home.
CONCLUSIONS: MRC score at weaning center admission predicted both early decannulation and limb-muscle strength recovery.
Footnotes
- Correspondence: Maxens Decavèle MD, Service de Pneumologie, Médecine Intensive - Réanimation, Hôpital Universitaire Pitié-Salpêtrière, 47–83 boulevard de l’Hôpital, 75651 Paris Cedex 13, France. E-mail: maxens.decavele{at}aphp.fr
- Copyright © 2022 by Daedalus Enterprises
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