Gerovasileiou Effrosyni, Menis Apostolis-Alkiviadis, Gavriilidis George, Magira Eleni, Temperikidis Prodromos, Papoti Sofia, Karavidas Nikitas, Spanos Michael, Zakynthinos Epaminondas, Makris Demosthenes
University Hospital of Larissa, Larissa, Greece.
G. Papanikolaou Hospital, Thessaloniki, Greece.
J Crit Care Med (Targu Mures). 2023 Jul 31;9(3):170-177. doi: 10.2478/jccm-2023-0021. eCollection 2023 Jul.
Data on risk factors associated with mechanical ventilation (MV) weaning failure among SARS-CoV2 ARDS patients is limited. We aimed to determine clinical characteristics associated with weaning outcome in SARS-CoV2 ARDS patients under MV.
To determine potential risk factors for weaning outcome in patients with SARS-CoV2 ARDS.
A retrospective observational study was conducted in the ICUs of four Greek hospitals via review of the electronic medical record for the period 2020-2021. All consecutive adult patients were screened and were included if they fulfilled the following criteria: a) age equal or above 18 years, b) need for MV for more than 48 hours and c) diagnosis of ARDS due to SARS-CoV2 pneumonia or primary or secondary ARDS of other aetiologies. Patient demographic and clinical characteristics were recorded for the first 28 days following ICU admission. The primary outcome was weaning success defined as spontaneous ventilation for more than 48 hours.
A hundred and fifty eight patients were included; 96 SARS-CoV2 ARDS patients. SOFA score, Chronic Obstructive Pulmonary Disease (COPD) and shock were independently associated with the weaning outcome OR(95% CI), 0.86 (0.73-0.99), 0.27 (0.08-0.89) and 0.30 (0.14-0.61), respectively]. When we analysed data from SARS-CoV2 ARDS patients separately, COPD [0.18 (0.03-0.96)] and shock [0.33(0.12 - 0.86)] were independently associated with the weaning outcome.
The presence of COPD and shock are potential risk factors for adverse weaning outcome in SARS-CoV2 ARDS patients.
关于严重急性呼吸综合征冠状病毒2型（SARS-CoV2）所致急性呼吸窘迫综合征（ARDS）患者机械通气（MV）撤机失败相关危险因素的数据有限。我们旨在确定MV支持下SARS-CoV2 ARDS患者撤机结局的临床特征。
确定SARS-CoV2 ARDS患者撤机结局的潜在危险因素。
通过回顾2020年至2021年期间四家希腊医院重症监护病房（ICU）的电子病历，进行了一项回顾性观察研究。对所有连续的成年患者进行筛查，符合以下标准者纳入研究：a）年龄18岁及以上；b）需要MV支持超过48小时；c）因SARS-CoV2肺炎或其他病因的原发性或继发性ARDS而诊断为ARDS。记录ICU入院后前28天患者的人口统计学和临床特征。主要结局为撤机成功，定义为自主通气超过48小时。
共纳入158例患者；其中96例为SARS-CoV2 ARDS患者。序贯器官衰竭评估（SOFA）评分、慢性阻塞性肺疾病（COPD）和休克与撤机结局独立相关[比值比（95%置信区间）分别为0.86（0.73 - 0.99）、0.27（0.08 - 0.89）和0.30（0.14 - 0.61）]。当我们单独分析SARS-CoV2 ARDS患者的数据时，COPD[0.18（0.03 - 0.96）]和休克[0.33（0.12 - 0.86）]与撤机结局独立相关。
COPD和休克的存在是SARS-CoV2 ARDS患者撤机不良结局的潜在危险因素。
