1. Clinical features, ventilatory management, and outcome of ARDS caused by COVID-19 are similar to other causes of ARDS
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Ferrando, Carlos, Suarez-Sipmann, Fernando, Mellado-Artigas, Ricard, Hernández, María, Gea, Alfredo, Arruti, Egoitz, Aldecoa, César, Martínez-Pallí, Graciela, Martínez-González, Miguel A., Slutsky, Arthur S., Villar, Jesús, Graciela, Martínez-Pallí, Mercadal, Jordi, Muñoz, Guido, Mellado, Ricard, Jacas, Adriana, Vendrell, Marina, Sánchez-Etayo, Gerard, Alcón, Amalia, Belda, Isabel, Agustí, Mercé, Carramiñana, Albert, Gracia, Isabel, Panzeri, Miriam, León, Irene, Balust, Jaume, Navarro, Ricard, Arguís, María José, Carretero, Maria José, Ibáñez, Cristina, Perdomo, Juan, López, Antonio, López, Manuel, Cuñat, Tomás, Ubré, Marta, Ojeda, Antonio, Calvo, Andrea, Rivas, Eva, Hurtado, Paola, Pujol, Roger, Martín, Nuria, Tercero, Javier, Sanahuja, Pepe, Magaldi, Marta, Coca, Miquel, del Rio, Elena, Martínez-Ocon, Julia, Masgoret, Paula, Caballero, Angel, Risco, Raquel, Gómez, Lidia, de Riva, Nicolás, Ruiz, Ana, Beatriz, Tena, Jaramillo, Sebastián, Balibrea, Jose María, de Lacy, Francisco Borja, Otero, Ana, Ibarzabal, Ainitze, Bravo, Raquel, Carreras, Anna, Martín-Barreda, Daniel, Alias, Alfonso Jesús, Balaguer, Mariano, Aliaga, Jorge, Almuedo, Alex, Alonso, Joan Ramón, Andrea, Rut, Angelès, Gerard Sergi, Arias, Marilyn, Aziz, Fátima, Badía, Joan Ramon, Barbeta, Enric, Torres, Toni, Batiste, Guillem, Benet, Pau, Borrat, Xavi, Borrell, María, Bragulat, Ernest, Carmona, Inmaculada, Castellà, Manuel, Castro, Pedro, Ceravalls, Joan, Comino, Oscar, Cucciniello, Claudia, De Deray, Clàudia, De Diego, Oriol, De la Matta, Paula, Farrero, Marta, Fernández, Javier, Fernández, Sara, Fernández, Anna, Ferrer, Miquel, Fervienza, Ana, Forga, María Tallo, Forné, Daniel, Galán, Clàudia, Gomez, Andrea, Guasch, Eduard, Tejero, Maria Hernández, Jiménez, Beltrán, Leyes, Pere, López, Teresa, Martínez, José Antonio, Muñoz, Jose, Nicolás, Josep Maria, Ortiz, José Tomás, Peiró, Anna, Pérez, Manuel, Poch, Esteban, Pujol, Margarida, Quintana, Eduard, Ramis, Bartomeu, Reverter, Enric, Rovira, Irene, Ruiz, Pablo, Sandoval, Elena, Schneider, Stefan, Sibila, Oriol, Solé, Carla, Soriano, Alex, Soy, Dolors, Suárez, M., Téllez, Adrián, Toapanta, Néstor David, Torres, Antoni, Urra, Xavier, Bordell, Alicia, Martín, Silvia, Andrés, Judith, Ruiz, Alberto Martínez, Medel, Gonzalo Tamayo, Villasante, Iñaki Bilbao, Clavero, Fernando Iturri, Álvarez, Covadonga Peralta, Herrera, Julia T., Trancho, Andrea García, Mandiola, Iñaki Sainz, Suarez, Carmen Ruano, Bocos, Angela Ruiz, Izagirre, Eneritz Urrutia, de Urbina Fernández, Pablo Ortiz, Apodaka, Naiara, Molano, Leire Prieto, Ganuza, Eunate, Vallinas, Iratxe, de Orte, Karmele, Paniagua, Celia González, Ortiz, Gemma, Pérez, Mireia, López, Marta, Bárcena, Estíbaliz, Urutxurtu, Erik, Maroño, Maria Jesús, Escontrela, Blanca, Ereñozaga, Aitziber, Lasuen, Deiene, Zabal, Ainhoa, Guereca, Ane, Adalia, Ramón, Zattera, Luigi, Hernandez, Irina Adalid, Altuna, Leire Larrañaga, Castells, Aina Serrallonga, Garcia, Adriana Vilchez, Núñez, María, Román, Lorena, Calvo, Francisco Javier Redondo, González, Ruben Villazala, González, Victor Baladron, Faba, Patricia, Montenegro, Omar, Ramírez, Natalia Bejarano, Contreras, Sergio Marcos, Rodríguez, Alejandro Garcia, Vázquez, Saleta Rey, Pérez, Cristina Garcia, Miguelez, Eva Higuera, Blanco, Irene Pérez, Rivera, David García, de la Fuente, Ane Martín, Pardo, Marta, Rodriguez, Vanessa, Bengoetxea, Unai, Ramasco, Fernando, Bernal, Sheila Olga Santidrián, Hernando, Alvar Santa Cruz, Domínguez, Beatriz, Lima, Ana Vázquez, Candela, Ángel, Bambaren, Ismael A. Acevedo, Blanco, Maria Isabel Albala, Montoiro, Paloma Alonso, Utrera, Fernando Álvarez, Esteruelas, Juan Avellanosa, López, Amal Azzam, Balvis, Alberto José Balvis, Martín, María Beltrán, Haserfaty, Jacobo Benatar, Camacho, Alberto Berruezo, Weimer, Laura Betolaza, del Mar Carbonell Soto, Maria, Seral, Cristina Carrasco, Zaballos, Cristina Cerro, Llamas, Elizabeth Claros, Orduna, Pilar Coleta, Forero, Ingrid P. Cortes, Agustín, Pascual, Aliseda, Crespo, de Pablo Pajares, María Angélica, Remesal, Yolanda Díez, Díaz, Trinidad Dorado, Blasco, Noemí Echevarría, Martín, María Elena Elías, Triviño, Javier Felices, López, Natalia Fernández, Martín, Cristina Fernández, Pozuelo, Natalia Ferreiro, Martín, Luis Gajate, Santos, Clara Gallego, Mayo, Diego Gil, Rojo, María Gómez, Cibrián, Claudia González, López, Elena Herrera, Olmedillo, Borja Hinojal, Gallego, Berta Iglesias, Khonsari, Sassan, Ruiz, María Nuria Mane, Arroyo, María Manzanero, Ortega, Ana María Mariscal, Burcio, Sara Martín, del Carmen Martín González, María, Grande, Ascensión Martín, López, Jose Juan Martín, Rabes, Cecilia Martín, Borja, Marcos Martínez, Castro, Nilda Martínez, Pérez, Adolfo Martínez, Matcan, Snejana, Viñas, Cristina Medrano, Herrera, Lisset Miguel, Betancur, Adrián Mira, Carbajo, María Montiel, Moradas, Javier Moya, Pérez, Lorena Muñoz, Murias, Mónica Nuñez, González, Eva Ordiales, Recio, Óscar Ordoñez, Rodriguez, Miguel Ángel Palomero, Roux, Diego Parise, Torres, Lucia Pereira, Lagunas, David Pestaña, Corraliza, Juana María Pinto, Rodrigo, Marian Prieto, Diaz-Regaño, Inmaculada Rodriguez, Esteban, David Rodriguez, Pernia, Víctor Rojas, Saiz, Álvaro Ruigómez, Villarino, Bárbara Saavedra, Palero, Noemí Samaranch, Pérez, Gloria Santos, Pérez, Jaume Serna, Romero, Ana Belén Serrano, López, Jesús Tercero, García, Carlos Tiscar, de la Torre Concostrina, Marta, Mesa, Eva María Ureta, Olarte, Eva Velasco, Martínez, Judith Villahoz, Palacios, Raúl Villalaba, García, Gema Villanueva, de Medeiros, Cristina Vogel, Ovejero, Soraya Gholamian, Orgaz, Marta Vicente, Herradon, Patricia Lloreda, Gómez, Cristina Crespo, Sarmiento-Trujillo, Tatiana, Medina, Noemí García, García, María Martínez, Ramírez, Carles Espinós, Rivero, Nabil Mouhaffel, Gil, Jose Antonio Bernia, Martín, Sonsoles, Moral, María Victoria, Galán, Josefina, Paniagua, Pilar, Pérez, Sergio, Bainac, Albert, Arias, Ana, Ramil, Elsa, Escudero, Jorge, Monedero, Pablo, Cara, Carmen, Lara, Andrea, Mendez Martínez, E., Mendoza, Jorge, Baines, Íñigo Rubio, Montero, Alejandro, Ibañez, Rocío Armero, Pitarch, Juan Vicente Llau, Alcover, Fernando Rauer, Herreros, Cristina Álvarez, Martín, Cyntia Sánchez, Olmos, Lucía López Ocáriz, Moruno, Marta Navas, Montoto, Fernando García, Rodriguez, M. F. Mirón, Gamito, Cristina Hernández, Orejudo, Antonio Barba, Vielma, Luis Gerardo Smith, Marín, Yasmina González, de Borja Amador Penco, Francisco, Domínguez, Marta Donoso, Ramírez, Silvia Esquivel, Carbonell, José Antonio, López, Berta Monleón, Martínez-Castro, Sara, Aguilar, Gerardo, Gestal, María, Casas, Pablo, Rosato, Angel Outeiro, Pan, Andrea Naveiro, Portela, María Alonso, Romar, Adrián García, Rodríguez, Eva Mosquera, Seijo, Diego Ruanova, Maceiras, Pablo Rama, Castro-Ceoane, Francisco, López, Esther Moreno, Gil, Sergio, Antón, Julia Guillén, Tirado, Patricia García-Consuegra, Calvo, Aurora Callau, Lisbona, Laura Forés, Romero, María Carbonell, Gil, Belén Albericio, Jarne, Laura Pradal, Lozano, María Soria, López, Diego Loscos, Abarca, Andrea Patiño, Pérez-Asenjo, Jordi Serrano Javier, Díez-Domínguez, Ángel, Zubizarreta, Ion, Ramos, Jon, Fernández, Iosu, Maseda, Emilio, de la Rica, Alejandro Suárez, Veganzones, Javier, Insausti, Itziar, Sagra, Javier, Carrasco, Sofía Díaz, Feijoo, Ana Montero, Garutti, Julio Yagüe. Ignacio, Parga, Eva Bassas, Garcia, Carmen Deiros, Rosa, Elisenda Pujol, Navarro, Ana Tejedor, Gabernet, Roser Font, Bernat, Maria José, Valls, Meritxell Serra, Garcia-Bernalt, Cristina Cobaleda, Anton, Jesus Fernanz, Sierra, Adriana Aponte, Gomez, Lucia Gil, Vaqueiro, Olaia Guenaga, Marin, Susana Hernandez, Pinzon, Laura Pardo, Aranda, Sira Garcia, Orejuela, Carlos Briones, Sanchez, Edgar Cortes, Fernandez, Alejandro Romero, Sanjosé, Esther Fernández, Garsabal, Patricia Iglesias, Lopez, Guillermo Isidro, Vicol, Ana, Malagon, Sara Espejo, Loewe, Maria Sanabra, Torradeflo, Laura Grau, Alcaide, Lourdes Blanco, Sanclemente, Gloria Buenaventura, Serra Pujol, Pere, Mendoza, Gustavo Cuadros, Konarska, Miroslawa, Almenara, Fedra Bachs, Golska, Agnieszka, Blesa, Aleix Carmona, Serra, Arantxa Mas, Melchor, Javier Ripollés, Moreno, Ana Nieto, Novo, Káteri Chao, López, Sandra Gadín, Moreno, Elena Nieto, Tonal, Bérénice Gutiérrez, de Pablo, Elena Lucena, Yañez, Barbara Algar, Rivero, Beatriz Vázquez, Mateo, Beatriz Nozal, de Retes, Marina, Escoda, Norma Aracil, Mayo, Cristina Gallardo, González, Rosa Sanz, Escobar, Alicia Ruiz, López, Maria Laura Pelegrina, Peña, Marina Valenzuela, Dueñas, David Stolle, Motos, Ane Abad, Abad-Gurumeta, Alfredo, Errazquin, Ana Tirado, Ruiz, Elena Sáez, Perez, Nerea Gómez, de Francisco, González, Borja Bau, Serra, Cesar Morcillo, Higueras, Jessica Souto, Vicente, Rosario, Ferrandis, Raquel, Martín, Silvia Polo, Moncho, Azucena Pajares, Puigdollers, Ignacio Moreno, Cortés, Juan Pérez Artacho, Calvo, Ana Moret, Peña, Ana Pi, Fernández, María Catalán, Varela, Marina, Diaz, Pilar, Chiva, María Isabel Forés, Agulló, A. Javier, Pérez, Antonio, Barrionuevo, María, Medrano, Paloma, Sanz, Cristina, Ortega, Manuel, Galiana, Maria, Margarit, Antoni, del Rio, Válerie Mourre, Muxella, Eva Heras, and Vidal, Anna
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Mechanical ventilation ,ARDS ,Acute respiratory distress syndrome ,business.industry ,Original ,medicine.medical_treatment ,Hazard ratio ,030208 emergency & critical care medicine ,medicine.disease ,Critical Care and Intensive Care Medicine ,3. Good health ,Coronavirus ,03 medical and health sciences ,Plateau pressure ,Prone position ,0302 clinical medicine ,030228 respiratory system ,Anesthesia ,Intensive care ,Breathing ,Medicine ,business ,Tidal volume ,Outcome - Abstract
Purpose The main characteristics of mechanically ventilated ARDS patients affected with COVID-19, and the adherence to lung-protective ventilation strategies are not well known. We describe characteristics and outcomes of confirmed ARDS in COVID-19 patients managed with invasive mechanical ventilation (MV). Methods This is a multicenter, prospective, observational study in consecutive, mechanically ventilated patients with ARDS (as defined by the Berlin criteria) affected with with COVID-19 (confirmed SARS-CoV-2 infection in nasal or pharyngeal swab specimens), admitted to a network of 36 Spanish and Andorran intensive care units (ICUs) between March 12 and June 1, 2020. We examined the clinical features, ventilatory management, and clinical outcomes of COVID-19 ARDS patients, and compared some results with other relevant studies in non-COVID-19 ARDS patients. Results A total of 742 patients were analysed with complete 28-day outcome data: 128 (17.1%) with mild, 331 (44.6%) with moderate, and 283 (38.1%) with severe ARDS. At baseline, defined as the first day on invasive MV, median (IQR) values were: tidal volume 6.9 (6.3–7.8) ml/kg predicted body weight, positive end-expiratory pressure 12 (11–14) cmH2O. Values of respiratory system compliance 35 (27–45) ml/cmH2O, plateau pressure 25 (22–29) cmH2O, and driving pressure 12 (10–16) cmH2O were similar cto values from non-COVID-19 ARDS observed in other studies. Recruitment maneuvers, prone position and neuromuscular blocking agents were used in 79%, 76% and 72% of patients, respectively. The risk of 28-day mortality was lower in mild ARDS [hazard ratio (RR) 0.56 (95% CI 0.33–0.93), p = 0.026] and moderate ARDS [hazard ratio (RR) 0.69 (95% CI 0.47–0.97), p = 0.035] when compared to severe ARDS. The 28-day mortality was similar to other observational studies in non-COVID-19 ARDS patients. Conclusions In this large series, COVID-19 ARDS patients have features similar to other causes of ARDS, compliance with lung-protective ventilation was high, and the risk of 28-day mortality increased with the degree of ARDS severity. Electronic supplementary material The online version of this article (10.1007/s00134-020-06192-2) contains supplementary material, which is available to authorized users.
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- 2020