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Research ArticleOriginal Research

Epidemiology of Weaning From Invasive Mechanical Ventilation in Subjects With COVID-19

Javier H Dorado, Emiliano Navarro, Gustavo A Plotnikow, Emiliano Gogniat and Matías Accoce on behalf of the EpVAr Study Group
Respiratory Care November 2022, respcare.09925; DOI: https://doi.org/10.4187/respcare.09925
Javier H Dorado
Capítulo de Kinesiología Intensivista, Sociedad Argentina de Terapia Intensiva, CABA, Argentina; and Sanatorio Anchorena San Martin, Provincia de Buenos Aires, Argentina.
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  • For correspondence: [email protected]
Emiliano Navarro
Capítulo de Kinesiología Intensivista, Sociedad Argentina de Terapia Intensiva, CABA, Argentina; and Centro del Parque, CABA, Argentina.
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Gustavo A Plotnikow
Capítulo de Kinesiología Intensivista, Sociedad Argentina de Terapia Intensiva, CABA, Argentina; Universidad Abierta Interamericana, Facultad de Medicina y Ciencias de la Salud, CABA, Argentina; Hospital Británico de Buenos Aires, CABA, Argentina; and Director del Grupo de Estudios Especializados en VM, Universidad Abierta Interamericana, CABA, Argentina.
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Emiliano Gogniat
Capítulo de Kinesiología Intensivista, Sociedad Argentina de Terapia Intensiva, CABA, Argentina.
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Matías Accoce
Capítulo de Kinesiología Intensivista, Sociedad Argentina de Terapia Intensiva, CABA, Argentina; Sanatorio Anchorena San Martin, Provincia de Buenos Aires, Argentina; and Universidad Abierta Interamericana. Facultad de Medicina y Ciencias de la Salud, CABA, Argentina.
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Abstract

BACKGROUND: Patients requiring mechanical ventilation due to COVID-19 have different characteristics of evolution and outcome compared to the general ICU population. Although early weaning from mechanical ventilation is associated with improved outcomes, inadequate identification of patients unable to be weaned may lead to extubation failure and increased days on mechanical ventilation. Outcomes related to mechanical ventilation weaning in this population are scare and inconclusive. Therefore, the objective of this study was to describe the characteristics of mechanical ventilation weaning in subjects with acute respiratory failure induced by COVID-19.

METHODS: This was a multi-center, prospective cohort study. We included adult subjects requiring at least 12 h of mechanical ventilation due to COVID-19 infection admitted to any participating ICUs. Characteristics of the mechanical ventilation weaning and extubation process, as well as clinical results, were the primary outcome variables. Weaning types were defined according to previously described and internationally recognized categories.

RESULTS: Three hundred twenty-six subjects from 8 ICUs were included. A spontaneous breathing trial (SBT) was not performed in 52.1% of subjects. One hundred twenty-eight subjects were extubated, and 29.7% required re-intubation. All the subjects included could be classified by Weaning according to a New Definition (WIND) classification (group 0 = 52.1%, group 1 = 28.5%, group 2 = 8.0%, and group 3 = 11.3%) with statistically significant differences in duration of mechanical ventilation (P < .001) and ICU length of stay (P < .001) between groups.

CONCLUSIONS: The mechanical ventilation weaning process in subjects with COVID-19 was negatively affected by the disease, with many subjects never completing an SBT. Even though temporal variables were modified, the clinical outcomes in each weaning group were similar to those previously reported.

  • mechanical ventilation
  • ICU
  • epidemiology
  • weaning mechanical ventilation
  • respiratory distress syndrome
  • COVID-19

Footnotes

  • Correspondence: Javier H Dorado PT, Elpidio Gonzalez 5350, ZIP1407 Buenos Aires, Argentina. E-mail: javierhdorado{at}gmail.com
  • Copyright © 2022 by Daedalus Enterprises

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Respiratory Care: 68 (1)
Respiratory Care
Vol. 68, Issue 1
1 Jan 2023
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Epidemiology of Weaning From Invasive Mechanical Ventilation in Subjects With COVID-19
Javier H Dorado, Emiliano Navarro, Gustavo A Plotnikow, Emiliano Gogniat, Matías Accoce
Respiratory Care Nov 2022, respcare.09925; DOI: 10.4187/respcare.09925

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Epidemiology of Weaning From Invasive Mechanical Ventilation in Subjects With COVID-19
Javier H Dorado, Emiliano Navarro, Gustavo A Plotnikow, Emiliano Gogniat, Matías Accoce
Respiratory Care Nov 2022, respcare.09925; DOI: 10.4187/respcare.09925
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Keywords

  • mechanical ventilation
  • ICU
  • epidemiology
  • weaning mechanical ventilation
  • respiratory distress syndrome
  • COVID-19

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