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Observational Study
. 2022 Jan 31;14(3):1087-1109.
doi: 10.18632/aging.203863. Epub 2022 Jan 31.

The effect of age on ventilation management and clinical outcomes in critically ill COVID-19 patients--insights from the PRoVENT-COVID study

Liselotte Hol  1 , Paula Van Oosten  2 , Sunny Nijbroek  1 , Anissa Tsonas  2 , Michela Botta  2 , Ary Serpa Neto  2   3   4 , Frederique Paulus  2   5 , Marcus Schultz  2   6   7 ; PRoVENT–COVID; Collaborative group
Affiliations
Observational Study

The effect of age on ventilation management and clinical outcomes in critically ill COVID-19 patients--insights from the PRoVENT-COVID study

Liselotte Hol et al. Aging (Albany NY). .

Abstract

Introduction: We analyzed the association of age with ventilation practice and outcomes in critically ill COVID-19 patients requiring invasive ventilation.

Methods: Posthoc analysis of the PRoVENT-COVID study, an observational study performed in 22 ICUs in the first 3 months of the national outbreak in the Netherlands. The coprimary endpoint was a set of ventilator parameters, including tidal volume normalized for predicted bodyweight, positive end-expiratory pressure, driving pressure, and respiratory system compliance in the first 4 days of invasive ventilation. Secondary endpoints were other ventilation parameters, the use of rescue therapies, pulmonary and extrapulmonary complications in the first 28 days in the ICU, hospital- and ICU stay, and mortality.

Results: 1122 patients were divided into four groups based on age quartiles. No meaningful differences were found in ventilation parameters and in the use of rescue therapies for refractory hypoxemia in the first 4 days of invasive ventilation. Older patients received more often a tracheostomy, developed more frequently acute kidney injury and myocardial infarction, stayed longer in hospital and ICU, and had a higher mortality.

Conclusions: In this cohort of invasively ventilated critically ill COVID-19 patients, age had no effect on ventilator management. Higher age was associated with more complications, longer length of stay in ICU and hospital and a higher mortality.

Keywords: COVID-19; age; coronavirus disease 2019; critical care; invasive ventilation; mortality.

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Conflict of interest statement

CONFLICTS OF INTEREST: Ary Serpa Neto reports personal fees from Dräger, outside of the submitted work. Marcus Schultz reports personal fees from Hamilton and Xenios/Novalung, outside of the submitted work. The other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Cumulative frequency distribution of median PEEP, tidal volume, compliance and driving pressure at start day of invasive ventilation. Mean values were calculated from three or four measurements available on the first day of ventilation. The Kruskal-Wallis test was used to calculate p-values.
Figure 2
Figure 2
Kaplan-Meier curves for 28-day and 90-day mortality per age group. The Log-Rank test was used to calculate P values.
See this image and copyright information in PMC

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