High PEEP/low FiO2 ventilation is associated with lower mortality in COVID–19
Year: 2024
Type: article
Study design: Observational Study
Abstract: The positive end–expiratory pressure (PEEP) strategy in patients with coronavirus 2019 (COVID–19) acute respiratory distress syndrome (ARDS) remains debated. Most studies originate from the initial waves of the pandemic. Here we aimed to assess the impact of high PEEP/low FiO2 ventilation on outcomes during the second wave in the Netherlands. Retrospective observational study of invasively ventilated COVID–19 patients during the second wave. Patients were categorized based on whether they received high PEEP or low PEEP ventilation according to the ARDS Network tables. The primary outcome was ICU mortality, and secondary outcomes included hospital and 90–day mortality, duration of ventilation and length of stay, and the occurrence of kidney injury. Propensity matching was performed to correct for factors with a known relationship to ICU mortality. This analysis included 790 COVID–ARDS patients. At ICU discharge, 32 (22.5%) out of 142 high PEEP patients and 254 (39.2%) out of 848 low PEEP patients had died (HR 0.66 [0.46–0.96]; P = 0.03). High PEEP was linked to improved secondary outcomes. Matched analysis did not change findings. High PEEP ventilation was associated with improved ICU survival in patients with COVID–ARDS.
Source: Journal of Critical Care
Authors: Robin L. Goossen, Relin van Vliet, Lieuwe D.J. Bos, Laura A. Buiteman-Kruizinga, Markus W. Hollman, Sheila N. Myatra, Ary Serpa Neto, Peter E. Spronk, Meta C.E. van der Woude, David M.P. van Meenen, Frederique Paulus, Marcus J. Schultz, S. Ahuja, J.P. van Akkeren, A.G. Algera, C.K. Algoe, R.B. van Amstel, A. Artigas, E. Aydeniz, M. Bailey, A.E. van den Berg, P. van de Berg, D.C.J.J. Bergmans, D.I. van den Bersselaar, F.A. Bertens, M. Bevers, A.J.G.H. Bindels, J.S. Breel, S. de Bruin, C.L. Bruna, M. de Boer, D.P. Boer, S. den Boer, L.S. Boers, M.B. Bogerd, L.D. Bos, B. Bosman, M. Botta, A.J.R. de Bie, O.L. Baur, L.A. Buiteman-Kruizinga, W. Coene, O.L. Cremer, K. Daenen, M. Delmte, R.M. Determann, W. Dieperink, V. Di Leo, J. van Dijk, D.A. Dongelmans, T. Dormans, H. Endeman, L.M. Elting, A.A. Esmeijer, D. Filippini, J.M. Flim, H.S. Franke, M.S. Galek-aldridge, M.G. Gama de Abreu, A.R. Girbes, D.M. Go, R.L. Goossen, M.J. de Graaff, L.A. Hagens, H.J. Hansen, J.J. Haringman, S.T. van der Heide, P.L.J. van der Heiden, N.F.L. Heijnen, S.J.P. Hiel, L.L. Hoeijmakers, L. Hol, M.W. Hollmann, M.E. Hoogendoorn, J. Horn, I. van der Horst, R. van der Horst, J.A. Huijben, E.L.K. Ie, L.E. van Ingen, D.P. Ivanov, N.P. Juffermans, H.T. Kranen, E. Kho, E.S. de Klerk, N. Koek, A.W.M.M. Koopman-van Gemert, M. Koopmans, S. Kucukcelebi, M.A. Kuiper, L.J. Kuipers, E. Koornstra, A. Lokhorst, D.W. de Lange, I. Martin-Loeches, D.M.P. van Meenen, G. Mazzinari, H. Moeniralam, N. van Mourik, S.N. Myatra, S.G. Nijbroek, P. van Oosten, M. Offermans, M. Onrust, E.A.N. Oostdijk, F. Paulus, C.J. Pennartz, J. Peršec, V.J.T. Peters, J.J. Pillay, L. Pisani, T. Pisters, A. Prins, I.M. Purmer, T.C.D. Rettig, A.S. Rezaee, O. Roca, J. Roozeman, J. Rozendaal, N.M. Rosenberg, R. Schavemaker, A. Sciascera, M.T.U. Schuijt, M.J. Schultz, A.S. Serpa Neto, G.S. Shrestha, B. van Silfhout, M. Sjoding, M.E. Sleeswijk, K.M. van Smaalen, M.R. Smit, P.E. Spronk, A. Šribar, A.C. Strang, W. Stilma, P. Swart, P.R. Tuinman, A.M. Tsonas, C.A. den Uil, C.M.A. Valk, F.L. Veen-Schra, A.P.J. Vlaar, L.I. Veldhuis, W.H. van der Ven, F.L.I.M. van der Ven, P. van Velzen, M. Verboom, E.J. Verhoef, T.D. Vermeulen, P. van Vliet, R. van Vliet, J.S. Voorham, P.H.J. van der Voort, L. van Welie, D. Weller, A.R. Wentink, H.J.F.T. Wesselink, H. van der Wier-Lubbers, B. van Wijk, H. van Willigen, M.C.E. van der Woude, J.J. Weiner, T. Winters, W.Y. Wong, N. Yaali, J.M. Zandvliet, A.R.H. van Zanten, T.Z.I. van Zijl, S.A. Zonneveld
Institutions: Amsterdam UMC Location University of Amsterdam, Amsterdam University Medical Centers, Reinier de Graaf Hospital, Homi Bhabha National Institute, Tata Memorial Hospital, The University of Melbourne, Hospital Israelita Albert Einstein, Monash University, Gelre Hospitals, Mahidol University, University of Oxford, Mahidol Oxford Tropical Medicine Research Unit, Medical University of Vienna
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,250
Funder: ZonMw
Award: G7521730281
OpenAlex ID: W4400528014