SESSION TITLE: Critical Care Posters
SESSION TYPE: Original Investigation Posters
PRESENTED ON: October 18-21, 2020
PURPOSE: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a public health crisis that has resulted in the death of thousands within the United States. The large influx of patients requiring mechanical ventilation for acute respiratory distress syndrome (ARDS) has necessitated the utilization of ventilators from a variety of sources. We hypothesized that ventilator model may be an independent risk factor for mortality in mechanically ventilated patients with COVID-19.
METHODS: We retrospectively reviewed the medical records of 147 patients admitted to the adult intensive care unit of a tertiary hospital [New York Presbyterian Queens (NYPQ), Flushing, NY] from 1 March 2020 to 2 April 2020 in whom COVID-19 was confirmed and mechanical ventilation was initiated. Patients <18 years old were excluded as were patients who were pregnant. Diagnosis of COVID-19 was based on a positive result from a probe-based reverse transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 from a nasopharyngeal swab. This observational retrospective study without any specific intervention was reviewed and exempted by the hospital Institutional Review Board, and all data were deidentified prior to processing.
RESULTS: Between 1 March 2020 to and 1 April 2020, we included 147 adult critically ill patients with confirmed COVID19 infection. The patients had a mean age of age of 60 ± 13 years, and 99/147 (67%) were men. 57/147 (39%) had a BMI >30 (Table 1). 87 of 147 patients were dead at 28 days. The 28-day mortality rate of mechanically ventilated patients with COVID-19 was 59%. As expected, the 28-day mortality rate was higher in patients who were >65 years old (p=0.02). Approximately, half of the patients were ventilated on the PB840, with the remaining divided evenly between the Servo-U and LTV1200. There was no association between ventilator type and 28-day mortality (p=0.73)
CONCLUSIONS: To the best of our knowledge, this study is the first to analyze various ventilator models and their relationships with patient outcome. With a myriad of ventilator types on the market, and more companies developing ventilators with the advent of this outbreak, healthcare providers must understand the limitations of each individual machine. Our data has limited power, but suggests that type of ventilator was not associated with drastically different outcomes.
CLINICAL IMPLICATIONS: We hope that this research serves as an impetus to the medical community to consider the features and limitations of the variety of ventilators being implemented during this crisis. Despite the trepidation we might have initially had using a limited, unfamiliar ventilator, there did not appear to be dramatic differences in outcomes with the LTV1200.
DISCLOSURES: Advisory Committee Member relationship with Ambu Please note: $1-$1000 by Olumayowa Abe, source=Admin input, value=Honoraria
No relevant relationships by Christian Castaneda, source=Web Response
No relevant relationships by Christine Eng, source=Web Response
No relevant relationships by Albert Magh, source=Web Response
No relevant relationships by Jack Mann, source=Web Response
No relevant relationships by Christina Jee Ah Rhee, source=Web Response
no disclosure on file for Lourdes Sanso;