Pulmonary embolism impacts clinical outcomes of intubated patients with acute respiratory distress syndrome related to COVID-19 - 17/02/24
, Tommaso Rochat Negro, Noémie Suh, Christophe Le Terrier, Hannah Wozniak, Jérôme Pugin, Karim Bendjelid
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Abstract |
Background |
Pulmonary embolism (PE) in critically ill patients with acute respiratory distress syndrome (ARDS) caused by COVID-19 is a major complication which might impact survival. We aimed to determine the prevalence of PE and assess its impact of PE on clinical outcomes in intubated patients with ARDS due to COVID-19.
Methods |
All intubated patients with ARDS due to COVID-19 admitted to the intensive care unit (ICU) of Geneva University Hospitals between March 9, 2020, and May 31, 2022, were included. A retrospective analysis was conducted on the occurrence of PE and its association with clinical outcomes. The primary outcome was ventilator-free days during the first 28 days after ICU admission. Linear regressions were performed to investigate the association between PE and outcomes.
Results |
Among the 370 intubated patients with ARDS related to COVID-19, 58 (15.7%) presented with PE. Patients with PE had significantly fewer ventilator-free days than patients without PE (median (IQR) of 3 (0−11) days versus 12 (0−19) days; p < 0.001). Mortality did not differ significantly between groups (12/58 [20.7%] of patients with PE versus 71/312 [22.8%] of patients without PE; p = 0.72). Duration of IMV, and ICU and hospital LOS were significantly longer among patients with PE. The need for ECMO support was similar among both groups.
Conclusions |
The occurrence of PE in patients with ARDS due to COVID-19 had a significant impact on clinical outcomes. They had fewer ventilator-free days, longer duration of IMV, and longer ICU and hospital lengths of stay. However, pulmonary embolism was not associated with higher mortality.
Ethics approval |
Ethical committee of Geneva (BASEC #: 2020-00917).
Le texte complet de cet article est disponible en PDF.Keywords : Acute respiratory distress syndrome, Pulmonary embolism, COVID-19, Invasive mechanical ventilation, Outcomes, Thrombosis
Plan
Vol 43 - N° 2
Article 101348- avril 2024 Retour au numéro
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