PaCO2 trajectories in mechanically ventilated patients with COVID-19: A population-based cohort study
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PaCO2 trajectories in mechanically ventilated patients with COVID-19 : A population-based cohort study. / Berg, Ronan M. G.; Ronit, Andreas; Haase, Nicolai; Moller, Morten Hylander; Kristiansen, Klaus. T. T.; Jonassen, Trine; Wamberg, Christian; Andreasen, Anne Sofie; Mohr, Thomas; Bestle, Morten. H. H.; Jorgensen, Vibeke. L. L.; Hammer, Niels. R. R.; Mitchell, Anja. U. U.; Smitt, Margit; Greve, Anders Møller; Nyeland, Martin Erik; Jensen, Britt Wang; Andreasen, Anne Helms; Petersen, Janne; Solem, Espen Jimenez; Winther-Jensen, Matilde; Plovsing, Ronni. R. R.
In: Acta Anaesthesiologica Scandinavica, Vol. 67, No. 6, 2023, p. 779-787.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - PaCO2 trajectories in mechanically ventilated patients with COVID-19
T2 - A population-based cohort study
AU - Berg, Ronan M. G.
AU - Ronit, Andreas
AU - Haase, Nicolai
AU - Moller, Morten Hylander
AU - Kristiansen, Klaus. T. T.
AU - Jonassen, Trine
AU - Wamberg, Christian
AU - Andreasen, Anne Sofie
AU - Mohr, Thomas
AU - Bestle, Morten. H. H.
AU - Jorgensen, Vibeke. L. L.
AU - Hammer, Niels. R. R.
AU - Mitchell, Anja. U. U.
AU - Smitt, Margit
AU - Greve, Anders Møller
AU - Nyeland, Martin Erik
AU - Jensen, Britt Wang
AU - Andreasen, Anne Helms
AU - Petersen, Janne
AU - Solem, Espen Jimenez
AU - Winther-Jensen, Matilde
AU - Plovsing, Ronni. R. R.
PY - 2023
Y1 - 2023
N2 - Objective: To identify PaCO2 trajectories and assess their associations with mortality in critically ill patients with coronavirus disease 2019 (COVID-19) during the first and second waves of the pandemic in Denmark. Design: A population-based cohort study with retrospective data collection.Patients: All COVID-19 patients were treated in eight intensive care units (ICUs) in the Capital Region of Copenhagen, Denmark, between March 1, 2020 and March 31, 2021. Measurements: Data from the electronic health records were extracted, and latent class analyses were computed based on up to the first 3 weeks of mechanical ventilation to depict trajectories of PaCO2 levels. Multivariable Cox regression analyses were used to calculate adjusted hazard ratios (aHRs) for Simplified Acute Physiology Score 3, sex and age with 95% confidence intervals (CIs) for death according to PaCO2 trajectories. Main results: In latent class trajectory models, including 25,318 PaCO2 measurements from 244 patients, three PaCO2 latent class trajectories were identified: a low isocapnic (Class I; n = 130), a high isocapnic (Class II; n = 80), as well as a progressively hypercapnic (Class III; n = 34) trajectory. Mortality was higher in Class II [aHR: 2.16 {1.26-3.68}] and Class III [aHR: 2.97 {1.63-5.40}]) compared to Class I (reference). Conclusion: Latent class analysis of arterial blood gases in mechanically ventilated COVID-19 patients identified distinct PaCO2 trajectories, which were independently associated with mortality.
AB - Objective: To identify PaCO2 trajectories and assess their associations with mortality in critically ill patients with coronavirus disease 2019 (COVID-19) during the first and second waves of the pandemic in Denmark. Design: A population-based cohort study with retrospective data collection.Patients: All COVID-19 patients were treated in eight intensive care units (ICUs) in the Capital Region of Copenhagen, Denmark, between March 1, 2020 and March 31, 2021. Measurements: Data from the electronic health records were extracted, and latent class analyses were computed based on up to the first 3 weeks of mechanical ventilation to depict trajectories of PaCO2 levels. Multivariable Cox regression analyses were used to calculate adjusted hazard ratios (aHRs) for Simplified Acute Physiology Score 3, sex and age with 95% confidence intervals (CIs) for death according to PaCO2 trajectories. Main results: In latent class trajectory models, including 25,318 PaCO2 measurements from 244 patients, three PaCO2 latent class trajectories were identified: a low isocapnic (Class I; n = 130), a high isocapnic (Class II; n = 80), as well as a progressively hypercapnic (Class III; n = 34) trajectory. Mortality was higher in Class II [aHR: 2.16 {1.26-3.68}] and Class III [aHR: 2.97 {1.63-5.40}]) compared to Class I (reference). Conclusion: Latent class analysis of arterial blood gases in mechanically ventilated COVID-19 patients identified distinct PaCO2 trajectories, which were independently associated with mortality.
KW - critical illness
KW - hypercapnia
KW - latent class trajectory model
KW - mechanical ventilation
KW - respiratory failure
U2 - 10.1111/aas.14233
DO - 10.1111/aas.14233
M3 - Journal article
C2 - 36915257
VL - 67
SP - 779
EP - 787
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
SN - 0001-5172
IS - 6
ER -
ID: 342926335