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. 2025 Feb;69(2):e14571.
doi: 10.1111/aas.14571.

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

Martine S Nielsen  1 , Ulrich Halekoh  2 , Anders Perner  3 , Trine Haberlandt  1 , Nikolai Arnold- Larsen  1 , Sarah Weihe  4 , Ricardo S Garcia  5 , Hanna Siegel  6 , Christian Hagdrup  7 , Mads R Skøtt  8 , Anne-Mette S Jensen  9 , Jonathan B Frische  10 , Kasper Wethelund  11 , Søren H Christiansen  11 , Søren R Aagaard  12 , Sofie Højlund  13 , Bo Westergaard  3 , Aage Christiansen  11 , George Michagin  13 , Marie S Worm  14 , Ann-Kristine M Svendsen  14 , Kirstine N la Cour  4 , Trine B Jonassen  7 , Jens U Jensen  15 , Kasper M Sørensen  16 , Nicolai Haase  3 , Bodil S Rasmussen  12 , Anne C Brøchner  1
Affiliations

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

Martine S Nielsen et al. Acta Anaesthesiol Scand. 2025 Feb.

Abstract

Aim: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: COVID‐19; adverse events; barotrauma; core strategies; mechanical ventilation.

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