Invasive mechanical ventilation strategies, adjuvants treatments and adverse events among ICU patients with COVID-19 in Denmark.

Abstract

To describe the use of invasive mechanical ventilation core strategies, adjuvant treatments and the occurrence of barotrauma and prolonged ventilation in ICU patients with COVID-19 in Denmark, retrospectively. All ICUs admitting COVID-19 patients in Denmark from 10 March 2020 to 2 April 2021 were invited to participate. All patients with COVID-19 who received invasive mechanical ventilation were included and data was retrospectively collected from electronic patient records. A total of 774 patients were invasively ventilated during the first two waves and included; 70% were males and the median age was 69 years. 340 (51.5%) of patients never exceeded tidal volumes of 8 mL/kg. For all patients, tidal volumes under 8 mL/kg were applied in 77.6% (IQR 54.5%-96.2%) of the time on ventilator in the ICU; plateau pressure was below 30 cm H₂O in 125 (80.6%) patients; prone positioning was used in 44.7% of patients. In ICU, 169 of 774 (21.8%) patients experienced barotrauma and 220 (28.4%) prolonged ventilation. At 90 days, 306 (39.5%) had died. Lung protective ventilation and prone positioning were used in many of the Danish ICU patients with COVID-19, but barotrauma, prolonged ventilation and death occurred frequently.