Successful Versus Failed Transition From Controlled Ventilation to Pressure Support Ventilation in COVID-19 Patients: A Retrospective Cohort Study
Melisa Polo Friz, Emanuele Rezoagli, Bijan Safaee Fakhr, Gaetano Florio, Eleonora Carlesso, Riccardo Giudici, Clarissa Forlini, Francesca Tardini, Thomas Langer, Matteo Laratta, Giampaolo Casella, Andrea Forastieri Molinari, Alessandro Protti, Maurizio Cecconi, Luca Cabrini, Emanuela Biagioni, Angela Berselli, Lucia Mirabella, Tommaso Tonetti, Edoardo De Robertis, Domenico Luca Grieco, Massimo Antonelli, Giuseppe Citerio, Roberto Fumagalli, Giuseppe Foti, Alberto Zanella, Giacomo Grasselli, Giacomo Bellani,- Critical Care and Intensive Care Medicine
OBJECTIVES:
In patients with COVID-19 respiratory failure, controlled mechanical ventilation (CMV) is often necessary during the acute phases of the disease. Weaning from CMV to pressure support ventilation (PSV) is a key objective when the patient’s respiratory functions improve. Limited evidence exists regarding the factors predicting a successful transition to PSV and its impact on patient outcomes.
DESIGN:
Retrospective observational cohort study.
SETTING:
Twenty-four Italian ICUs from February 2020 to May 2020.
PATIENTS:
Mechanically ventilated ICU patients with COVID-19-induced respiratory failure.
INTERVENTION:
The transition period from CMV to PSV was evaluated. We defined it as “failure of assisted breathing” if the patient returned to CMV within the first 72 hours.
MEASUREMENTS AND MAIN RESULTS:
Of 1260 ICU patients screened, 514 were included. Three hundred fifty-seven patients successfully made the transition to PSV, while 157 failed. Pa
CONCLUSIONS:
Our study emphasizes that the Pa