Early extubation in COVID-19 pneumonia patients and temporal changes in the lactate dehydrogenase profile

ABSTRACT

Objective: Since the beginning of the 2019 global pandemic of Coronavirus Disease, using invasive mechanical ventilation as support therapy has been a critical treatment of acute respiratory failure. In the context of a collapsed health system, having an early extubation predictor becomes a useful way of supporting clinical management, by enabling to anticipate the availability of mechanical ventilators. Hence, we assessed the relationship between the progression of lactate dehydrogenase and early extubation in patients with COVID-19. Design: A retrospective study. Setting: A single private hospital in Chile. Patients Adults aged 18 or older diagnosed with COVID-19 pneumonia and requiring mechanical ventilation, having been admitted to an ICU during the study period. Interventions: None. Measurements and Main Results: Fifty two individuals, 73% males, were included with a median age of 47.1 years old and a median body mass index of 29. Individuals extubated within the first 5 days of mechanical ventilation, early extubation group, amounted to 34.6%. The average decrease in serum lactate dehydrogenase levels was 27.5 UI/L per day (p < 0.01) in the early extubation group compared to 14.7 UI/L per day (p < 0.01) in the late extubation group (individuals extubated after day 5). During the first 48 hours, the average daily decrease was 56.7 UI/L in the early extubation group compared to 13.2 UI/L per day in late extubation group (p < 0.01). Conclusions: Serum lactate dehydrogenase daily level decrease during the first days of mechanical ventilation is associated with earlier patient extubation. © 2022 Sociedad de Anestesiologia de Chile. All rights reserved.