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2022, Number 5

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Med Crit 2022; 36 (5)

Invasive mechanical ventilation in patients with COVID-19 in a private hospital in Mexico. A case series: description and evolution of an early intubation protocol

Rosas-Sánchez K, Gutiérrez-Zárate D, Severino-Lugo H, Santiago-Germán D
Full text How to cite this article 10.35366/106514

DOI

DOI: 10.35366/106514
URL: https://dx.doi.org/10.35366/106514

Language: Spanish
References: 10
Page: 318-322
PDF size: 252.43 Kb.


Key words:

Mechanical ventilation, COVID-19, acute respiratory distress syndrome, critical ill patient.

ABSTRACT

The mortality and ventilation strategies of COVID-19 ARDS vary in the literature. The objective of this case series is to describe the clinical course of patients on invasive mechanical ventilation with COVID-19 and its outcome at 28 days. Twenty-one patients were included with an average age of 49 ± 13 years, 81% male and 38% with at least one comorbidity. The initial ventilatory variables were PaO2/FiO2 of 135 ± 53, PEEP 12 cmH2O, plateau pressure 26 ± 4.8 cmH2O, static compliance 32 ± 8.5 mL/cmH2O, driving pressure 15 ± 3.9 cmH2O, and mechanical power 19.2 ± 4 J/min. 67% of the patients received prone position and in 76% a neuromuscular blocker was used. The 28-day outcomes were 21 days of mechanical ventilation-free days and 14% mortality.


REFERENCES

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  2. Fan E, Del Sorbo L, Goligher EC, et al. An official american thoracic society/european society of intensive care medicine/society of critical care medicine clinical practice guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 2017;195:1253-1263.

  3. Ferrando C, Mellado-Artigas R, Gea A, et al. Awake prone positioning does not reduce the risk of intubation in COVID-19 treated with high-flow nasal oxygen therapy: a multicenter, adjusted cohort study. Crit Care. 2020;24(1):597.

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  5. Mauri T, Spinelli E, Scotti E, et al. Potential for lung recruitment and ventilation-perfusion mismatch in patients with the acute respiratory distress syndrome from coronavirus disease 2019. Crit Care Med. 2020;48(8):1129-1134.

  6. Fan E, Beitler JR, Brochard L, et al. COVID-19-associated acute respiratory distress syndrome: is a different approach to management warranted? Lancet Respir Med. 2020;8(8):816-821.

  7. Carsetti A, Damia Paciarini A, Marini B, Pantanetti S, Adrario E, Donati A. Prolonged prone position ventilation for SARS-CoV-2 patients is feasible and effective. Crit Care. 2020;24(1):225.

  8. Ferrando C, Suarez-Sipmann F, Mellado-Artigas R, et al. Clinical features, ventilatory management, and outcome of ARDS caused by COVID-19 are similar to other causes of ARDS. Intensive Care Med. 2020;46(12):2200-2211. doi: 10.1007/s00134-020-06192-2.

  9. Wang Y, Lu X, Li Y, et al. Clinical course and outcomes of 344 intensive care patients with COVID-19. Am J Respir Crit Care Med. 2020;201(11):1430-1434.

  10. Ñamendys-Silva SA, Gutiérrez-Villaseñor A, Romero-González JP. Hospital mortality in mechanically ventilated COVID-19 patients in Mexico. Intensive Care Med. 2020;46(11):2086-2088.




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Med Crit. 2022;36