Ventilator Strategies in ICU Patients With COVID-19 - a National-wide Retrospective Observational Study.

Study Overview
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Brief Summary
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Mechanical ventilation is likely lifesaving in patients with coronavirus disease 2019 (COVID-19) but may also result in adverse events. Only few studies describe the strategies used and adverse effect of mechanical ventilation in an unselected population of ICU patients with COVID-19. This study is designed to be a retrospective study focusing on all mechanical ventilated ICU patients with COVID-19 included in the national Danish COVID ICU database between 10.03.2020 - 02.04.2021 i.e. a total of 1,193 patients. The investigators will register the use of the core interventions around mechanical ventilation and its potential adverse event, including barotrauma and prolonged ventilation. This study will provide important data on the ventilation strategies used and its potential adverse events in unselected ICU patients with COVID-19 and thereby inform clinicians, patients, policy-makers, and future research in this area.

Official Title
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The Use of Mechanical Ventilation Strategies and Its Potential Adverse Events Among ICU Patients With COVID-19 - a National-wide Retrospective Observational Study.

Conditions
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ARDS Due to COVID-19

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All mechanical ventilated patients registered in the national Danish COVID ICU database between 10.03.2020 - 02.04.2021 i.e. Admitted to an ICU in Denmark Laboratory-confirmed SARS-CoV-2 infection Use of invasive mechanical ventilation (ventilation via a cuffed endotracheal tube) at any time during the ICU stay Exclusion Criteria: None
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ventilator days with lung -protective ventilation in percent of all ventilation days with 95%-CI. | Low tidal volume ventilation (Vt 4-8 mL/kg of predicted body weight) | Until 90 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pneumothorax | Pneumothorax noted in the medical record | Until 90 days | 
| Ventilator days | Number of days where the patients where the patient is ventilator depended | Until 90 days | 
| Number of patients with prolonged ventilation | Patients with more than 30 ventilator days | Until 90 days | 
| paO2/FiO2 ratio on days of ventilation | Ratio between measured arterial oxygen pressure and the fraction of inhaled oxygen | Until 90 days | 
| The use of APRV | The use of Airway pressure release as primary ventilator setting | Until 90 days | 
| Prone position | The use of prone position within the first 3 days and the use of prone position after day 3 | Until 90 days | 
| Time to spontaneous ventilation | Time measured in days until the patients no longer needs controlled ventilation | Until 90 days | 
| Tracheostomy | Day after first intubation, Percutaneous dilatational tracheostomy (y/n), Surgical tracheostomy (y/n) | Until 90 days | 
| Adjuvant drugs | Adjuvant drugs at any time during mechanical ventilation | Until 90 days | 
| Mortality | Mortality at day 90 | Until 90 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ARDS, Mechanical Ventilation, COVID-19