Intubation timing as determinant of outcome in patients with acute respiratory distress syndrome by SARS-CoV-2 infection

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dc.contributor.authorVera Alarcón, María Magdalena
dc.contributor.authorKattan Tala, Eduardo José
dc.contributor.authorBorn, Pablo
dc.contributor.authorRivas, E.
dc.contributor.authorAmthauer, M.
dc.contributor.authorNesvadba, A.
dc.contributor.authorLara, Bárbara
dc.contributor.authorRao, I.
dc.contributor.authorEspíndola, Eduardo
dc.contributor.authorRojas Orellana, Luis
dc.contributor.authorHernández Poblete, Glenn
dc.contributor.authorBugedo Tarraza, Guillermo
dc.contributor.authorCastro López, Ricardo
dc.date.accessioned2023-06-06T20:51:40Z
dc.date.available2023-06-06T20:51:40Z
dc.date.issued2021
dc.description.abstractBackground: SARS-CoV-2 infection presents in many cases with pneumonia and respiratory failure. It is not clear whether the time of intubation and connection to mechanical ventilation (MV) in this condition is associated with an increase in mortality or represents the natural course of the disease. We conducted an observational, prospective, single-center study to describe the characteristics and outcomes of acute respiratory distress syndrome (ARDS) patients with confirmed COVID-19 and treated with invasive MV to determine whether the time-to-intubation following hospital admission is associated with worse outcomes. Methods: We prospectively included consecutive patients with SARS-CoV-2 infection and moderate to severe ARDS, admitted to an intensive care unit (ICU) and connected to MV between March 17 and July 31, 2020. We examined their general characteristics, ventilatory management, and clinical outcomes. Time of intubation was defined as the time from hospital admission to endotracheal intubation and was categorized as early (<72 hours) or late (≥72 hours). Mann-Whitney U, Kruskal Wallis, chi-square, and Fisher’s exact, were used when appropriate. Uni and multivariate analyses between main outcome and explanatory variables were performed. Results: A total of 183 consecutive patients were included, 28% (51/183) were female, and their median age was 62 years [54-70]. One hundred (55%) patients were subjected to early and 83 (45%) to late intubation. Patients intubated after 72 hours were older and presented more comorbidities. Mortality was higher in the group of patients with late intubation (41% versus 21%; p= 0.002), a PaO2/FiO2 ratio <100 mmHg at admission (p= 0.029), and that were older than 60 years (p= 0.008). Conclusions: In acute COVID-19 patients with moderate to severe ARDS, intubation after 72 hours following hospital admission, age >60 years-old and a PaO2/FiO2 ratio <100 at admission may appear to be associated with increased ICU mortality. Further studies are required to confirm our findings and establish the best timing for intubation in COVID-19 patients admitted to the ICU with respiratory failure.
dc.fechaingreso.objetodigital2023-06-06
dc.format.extent6 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.jcrc.2021.06.008
dc.identifier.issn0883-9441
dc.identifier.scopusidScopus_ID:85108265951
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/70533
dc.identifier.urihttps://doi.org/10.1016/j.jcrc.2021.06.008
dc.identifier.wosidWOS:000704365400026
dc.information.autorucEscuela de Medicina; Vera Alarcón, María Magdalena; 0000-0002-2969-3408; 226652
dc.information.autorucEscuela de Medicina; Kattan Tala, Eduardo Jose; 0000-0002-1997-6893; 172152
dc.information.autorucEscuela de Medicina; Born, Pablo; 0009-0002-6370-7372; 223841
dc.information.autorucEscuela de Medicina; Rivas Garrido, Elizabeth Alexis; S/I; 1011538
dc.information.autorucEscuela de Medicina; Amthauer Rojas, Macarena; S/I; 163666
dc.information.autorucEscuela de Medicina; Nesvadba Comelin, Annael; S/I; 1027992
dc.information.autorucEscuela de Medicina; Lara Hernandez, Barbara Alejandra; 0000-0002-0265-808X; 149938
dc.information.autorucEscuela de Medicina; Rao Shuai, Isabel; S/I; 1027986
dc.information.autorucEscuela de Medicina; Espíndola, Eduardo; S/I; 1031783
dc.information.autorucEscuela de Medicina; Rojas Orellana, Luis; 0000-0002-0234-5876; 135613
dc.information.autorucEscuela de Medicina; Hernández P., Glenn; 0000-0002-3032-4087; 98874
dc.information.autorucEscuela de Medicina; Bugedo Tarraza, Guillermo; 0000-0001-7527-6202; 60490
dc.information.autorucEscuela de Medicina; Castro López, Ricardo; 0000-0002-0978-9891; 4537
dc.language.isoen
dc.nota.accesocontenido parcial
dc.revistaJournal of Critical Care
dc.rightsacceso restringido
dc.rights.licenseCreative Commons Attribution 4.0 International License
dc.subjectSARS-CoV-2
dc.subjectCOVID-19
dc.subjectARDS
dc.subjectMechanical ventilation
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleIntubation timing as determinant of outcome in patients with acute respiratory distress syndrome by SARS-CoV-2 infection
dc.typeartículo
sipa.codpersvinculados226652
sipa.codpersvinculados172152
sipa.codpersvinculados223841
sipa.codpersvinculados1011538
sipa.codpersvinculados163666
sipa.codpersvinculados1027992
sipa.codpersvinculados149938
sipa.codpersvinculados1027986
sipa.codpersvinculados1031783
sipa.codpersvinculados135613
sipa.codpersvinculados98874
sipa.codpersvinculados60490
sipa.codpersvinculados4537
sipa.trazabilidadWOS;18-03-2022
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