publication . Article . 2021

Associations of Body Mass Index with Ventilation Management and Clinical Outcomes in Invasively Ventilated Patients with ARDS Related to COVID-19—Insights from the PRoVENT-COVID Study

Schavemaker, Renée; Schultz, Marcus J; Lagrand, Wim K; van Slobbe-Bijlsma, Eline R; Serpa Neto, Ary; Paulus, Frederique; For The PRoVENT-Covid,; Collaborative Group,; Study group members AMC,; de Klerk, Eline S.; ...
Open Access
  • Published: 01 Mar 2021 Journal: Journal of Clinical Medicine, volume 10, page 1,176 (eissn: 2077-0383, Copyright policy)
  • Publisher: MDPI AG
  • Country: Netherlands
Abstract
30 kg/m2) COVID-19 ARDS patients in a national, multicenter observational study, performed at 22 intensive care units in the Netherlands. The primary outcome was a combination of ventilation variables and parameters over the first four calendar days of ventilation, including tidal volume, positive end–expiratory pressure (PEEP), respiratory system compliance, and driving pressure in normal–weight, overweight, and obese patients. Secondary outcomes included the use of adjunctive treatments for refractory hypoxaemia and mortality rates. Between 1 March 2020 and 1 June 2020, 1122 patients were included in the study: 244 (21.3%) normal-weight patients, 531 (47.3%) overweight patients, and 324 (28.8%) obese patients. Most patients received a tidal volume &lt
only on the first day was the tidal volume higher in obese patients. PEEP and driving pressure were higher, and compliance of the respiratory system was lower in obese patients on all four days. Adjunctive therapies for refractory hypoxemia were used equally in the three BMI groups. Adjusted mortality rates were not different between BMI categories. The findings of this study suggest that lung-protective ventilation with a lower tidal volume and prone positioning is similarly feasible in normal-weight, overweight, and obese patients with ARDS related to COVID-19. A patient’s BMI should not be used in decisions to forgo or proceed with invasive ventilation.
We describe the practice of ventilation and mortality rates in invasively ventilated normal-weight (18.5 ≤ BMI ≤ 24.9 kg/m2), overweight (25.0 ≤ BMI ≤ 29.9 kg/m2), and obese (BMI &gt
8 mL/kg PBW
Fields of Science and Technology classification (FOS)
03 medical and health sciences, 0302 clinical medicine, 030212 general & internal medicine, 030228 respiratory system
Sustainable Development Goals (SDG)
2. Zero hunger
Subjects
Medical Subject Headings: nutritional and metabolic diseases
free text keywords: General Medicine, coronavirus disease 2019, COVID-19, ARDS, body mass index, BMI, normal-weight overweight, obesity, obesity paradox, intensive care, critical care, artificial ventilation, mortality, RESPIRATORY-DISTRESS-SYNDROME, SURVIVAL, Article, Breathing, Medicine, business.industry, business, Hypoxemia, medicine.symptom, Artificial ventilation, medicine.medical_treatment, Intensive care, Anesthesia, Overweight, ARDS, medicine.disease, Body mass index, Tidal volume, lcsh:Medicine, lcsh:R
Communities
  • COVID-19
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