Mechanical Ventilation Needed by Most COVID-19 Patients in ICU
Study from Lombardy, Italy, shows large number were older men; ICU mortality rate 26 percent
MONDAY, April 13, 2020 (HealthDay News) -- Most patients with coronavirus disease 2019 (COVID-19) requiring treatment in an intensive care unit (ICU) require mechanical ventilation, according to a study published online April 6 in the Journal of the American Medical Association.
Giacomo Grasselli, M.D., from Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico in Milan, and colleagues examined clinical characteristics of 1,591 consecutive patients (82 percent male) with laboratory-confirmed COVID-19 requiring treatment in an ICU in the Lombardy region of Italy.
The researchers found that of the 1,043 patients with available data, 68 percent had at least one comorbidity and 49 percent had hypertension. Overall, 99 percent of the 1,300 patients with available respiratory support data needed respiratory support, including 88 and 11 percent who received mechanical ventilation and noninvasive ventilation, respectively. The median positive end-expiratory pressure (PEEP) was 14 cm H2O, and in 89 percent of patients, the fraction of inspired oxygen was greater than 50 percent. Younger and older patients did not have a difference in median PEEP level. Of the 1,581 patients with ICU disposition data available as of March 25, 2020, 58, 16, and 26 percent were still in the ICU, were discharged from the ICU, and had died in the ICU, respectively.
"The volume of critically ill patients with COVID-19 infection that ICUs might be required to manage may be substantial, and adequate ICU capacity to deal with severe respiratory failure should be planned," the authors write.
Several authors disclosed financial ties to the biopharmaceutical industry.