Department of Anesthesiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.
Department of Intensive Care, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.
Aging (Albany NY). 2022 Jan 31;14(3):1087-1109. doi: 10.18632/aging.203863.
We analyzed the association of age with ventilation practice and outcomes in critically ill COVID-19 patients requiring invasive ventilation.
Posthoc analysis of the PRoVENT-COVID study, an observational study performed in 22 ICUs in the first 3 months of the national outbreak in the Netherlands. The coprimary endpoint was a set of ventilator parameters, including tidal volume normalized for predicted bodyweight, positive end-expiratory pressure, driving pressure, and respiratory system compliance in the first 4 days of invasive ventilation. Secondary endpoints were other ventilation parameters, the use of rescue therapies, pulmonary and extrapulmonary complications in the first 28 days in the ICU, hospital- and ICU stay, and mortality.
1122 patients were divided into four groups based on age quartiles. No meaningful differences were found in ventilation parameters and in the use of rescue therapies for refractory hypoxemia in the first 4 days of invasive ventilation. Older patients received more often a tracheostomy, developed more frequently acute kidney injury and myocardial infarction, stayed longer in hospital and ICU, and had a higher mortality.
In this cohort of invasively ventilated critically ill COVID-19 patients, age had no effect on ventilator management. Higher age was associated with more complications, longer length of stay in ICU and hospital and a higher mortality.
我们分析了年龄与 COVID-19 危重症患者接受有创通气时通气实践和结局的关系。
对 PRoVENT-COVID 研究的事后分析，该观察性研究在荷兰全国疫情爆发的头 3 个月内在 22 个 ICU 进行。主要终点是一组通气参数，包括有创通气的前 4 天内潮气量与预测体重的比值、呼气末正压、驱动压和呼吸系统顺应性。次要终点是其他通气参数、在有创通气的前 28 天内使用抢救治疗、肺和肺外并发症、住院和 ICU 住院时间以及死亡率。
根据年龄四分位数将 1122 名患者分为四组。在前 4 天的有创通气中，在通气参数和治疗难治性低氧血症的抢救治疗方面，各组之间没有明显差异。老年患者更常接受气管切开术，更常发生急性肾损伤和心肌梗死，住院和 ICU 停留时间更长，死亡率更高。
在本队列中，接受有创通气的 COVID-19 危重症患者中，年龄对通气管理没有影响。年龄较大与更多并发症、更长的 ICU 和住院时间以及更高的死亡率相关。
