Early experience with critically ill patients with COVID-19 in Montreal
PURPOSE: Montreal has been the epicentre of the coronavirus disease (COVID-19) pandemic in Canada. Given the regional disparities in incidence and mortality in the general population, we aimed to describe local characteristics, treatments, and outcomes of critically ill COVID-19 patients in Montreal.
METHODS: A single-centre retrospective cohort of consecutive adult patients admitted to the intensive care unit (ICU) of Hôpital du Sacré-Coeur de Montréal with confirmed COVID-19 were included.
RESULTS: Between 20 March and 13 May 2020, 75 patients were admitted, with a median [interquartile range (IQR)] age of 62 [53-72] yr and high rates of obesity (47%), hypertension (67%), and diabetes (37%). Healthcare-related infections were responsible for 35% of cases. The median [IQR] day 1 sequential organ failure assessment score was 6 [3-7]. Invasive mechanical ventilation (IMV) was used in 57% of patients for a median [IQR] of 11 [5-22] days. Patients receiving IMV were characterized by a moderately decreased median [IQR] partial pressure of oxygen:fraction of inspired oxygen (day 1 PaO2:FiO2 = 177 [138-276]; day 10 = 173 [147-227]) and compliance (day 1 = 48 [38-58] mL/cmH2O; day 10 = 34 [28-42] mL/cmH2O) and very elevated estimated dead space fraction (day 1 = 0.60 [0.53-0.67]; day 10 = 0.72 [0.69-0.79]). Overall hospital mortality was 25%, and 21% in the IMV patients. Mortality was 82% in patients ≥ 80 yr old.
CONCLUSIONS: Characteristics and outcomes of critically ill patients with COVID-19 in Montreal were similar to those reported in the existing literature. We found an increased physiologic dead space, supporting the hypothesis that pulmonary vascular injury may be central to COVID-19-induced lung damage.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:68 |
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| Enthalten in: |
Canadian journal of anaesthesia = Journal canadien d'anesthesie - 68(2021), 2 vom: 16. Feb., Seite 204-213 |
| Sprache: |
Englisch |
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| Weiterer Titel: |
Expériences initiales avec les patients atteints de la COVID-19 en état critique à Montréal |
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| Beteiligte Personen: |
Cavayas, Yiorgos Alexandros [VerfasserIn] |
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| Links: |
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| Themen: |
Acute respiratory distress syndrome |
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| Anmerkungen: |
Date Completed 03.02.2021 Date Revised 03.01.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s12630-020-01816-z |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM315072059 |
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| 100 | 1 | |a Cavayas, Yiorgos Alexandros |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Early experience with critically ill patients with COVID-19 in Montreal |
| 246 | 3 | 3 | |a Expériences initiales avec les patients atteints de la COVID-19 en état critique à Montréal |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 03.02.2021 | ||
| 500 | |a Date Revised 03.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: Montreal has been the epicentre of the coronavirus disease (COVID-19) pandemic in Canada. Given the regional disparities in incidence and mortality in the general population, we aimed to describe local characteristics, treatments, and outcomes of critically ill COVID-19 patients in Montreal | ||
| 520 | |a METHODS: A single-centre retrospective cohort of consecutive adult patients admitted to the intensive care unit (ICU) of Hôpital du Sacré-Coeur de Montréal with confirmed COVID-19 were included | ||
| 520 | |a RESULTS: Between 20 March and 13 May 2020, 75 patients were admitted, with a median [interquartile range (IQR)] age of 62 [53-72] yr and high rates of obesity (47%), hypertension (67%), and diabetes (37%). Healthcare-related infections were responsible for 35% of cases. The median [IQR] day 1 sequential organ failure assessment score was 6 [3-7]. Invasive mechanical ventilation (IMV) was used in 57% of patients for a median [IQR] of 11 [5-22] days. Patients receiving IMV were characterized by a moderately decreased median [IQR] partial pressure of oxygen:fraction of inspired oxygen (day 1 PaO2:FiO2 = 177 [138-276]; day 10 = 173 [147-227]) and compliance (day 1 = 48 [38-58] mL/cmH2O; day 10 = 34 [28-42] mL/cmH2O) and very elevated estimated dead space fraction (day 1 = 0.60 [0.53-0.67]; day 10 = 0.72 [0.69-0.79]). Overall hospital mortality was 25%, and 21% in the IMV patients. Mortality was 82% in patients ≥ 80 yr old | ||
| 520 | |a CONCLUSIONS: Characteristics and outcomes of critically ill patients with COVID-19 in Montreal were similar to those reported in the existing literature. We found an increased physiologic dead space, supporting the hypothesis that pulmonary vascular injury may be central to COVID-19-induced lung damage | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Brunette, Veronique |e verfasserin |4 aut | |
| 700 | 1 | |a Williamson, David |e verfasserin |4 aut | |
| 700 | 1 | |a Frenette, Anne Julie |e verfasserin |4 aut | |
| 700 | 1 | |a Arsenault, Christine |e verfasserin |4 aut | |
| 700 | 1 | |a Bellemare, Patrick |e verfasserin |4 aut | |
| 700 | 1 | |a Lagrenade-Verdant, Colin |e verfasserin |4 aut | |
| 700 | 1 | |a LeGuillan, Soazig |e verfasserin |4 aut | |
| 700 | 1 | |a Levesque, Emilie |e verfasserin |4 aut | |
| 700 | 1 | |a Lamarche, Yoan |e verfasserin |4 aut | |
| 700 | 1 | |a Giasson, Marc |e verfasserin |4 aut | |
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