VENTILATOR MECHANICS AND OUTCOMES IN CRITICALLY ILL PATIENTS WITH COVID-19 INFECTION

ABSTRACT

SESSION TITLE Critical Care Posters SESSION TYPE Original Investigation Posters PRESENTED ON October 18-21, 2020 PURPOSE: COVID-19 has affected millions of people all over the world with high mortality. This impact is greater in the low socioeconomic patient population. There has been debate on whether the ARDS due to COVID-19 is typical ARDS or the variant phenotypes L and H. We describe the clinical characteristics, ventilator mechanics, and outcomes in an underserved African American patient population. METHODS: This is a single-center retrospective observational study. We included all adult patients with laboratory-confirmed COVID-19 discharged from our ICU between March 15-April 25, 2020. We collected demographic data, laboratory values, respiratory mechanics and clinical outcomes RESULTS: Sixty-one critical ill adult patients with confirmed SARS-Cov-2 were included in the study. Median age was 70 (IQR 61-77) and 31 patients (51%) were female. 21% of patients had preexisting pulmonary disease and almost half were current or former smokers. Hypertension was present in 85% and Diabetes Mellitus in 62% of the patients. Fifty-one patients (83.6%) had two or more comorbidities. On intubation the median PEEP was 8 cm H2O (IQR 5-10), plateau pressure was 25 cm H2O (IQR22-30) and compliance was 26 ml/cmH2O (IQR 21-33). There was a significantly lower mean PF ratio on admission compared to PF ratios 3 days after (p=0.014). The FiO2 requirements were significantly higher on admission compared to 3 days after (89.62 vs 57.71 p=0.005). Compliance increased from the date of admission to day 3 but was not statistically significant. Mechanical ventilation was required in 82% of patients. Prone positioning was done for 30% of patients and had less mortality of 29.7% vs 36.8% (p=0.763). Overall, the mortality rate was 66%. Withdrawal of care was done in 37.7% of patients. Successful extubation rate was 23%. CONCLUSIONS: Our patients presented with the typical low compliance ARDS. The mortality in critically ill COVID-19 patients is high. Increasing age, African Americans, and patients with multiple comorbid conditions are at increased risk of morbidity and mortality. CLINICAL IMPLICATIONS N/A DISCLOSURES No relevant relationships by Zurab Azmaiparashvili, source=Web Response No relevant relationships by Sadia Benzaquen, source=Web Response No relevant relationships by Siddique Chaudhary, source=Web Response No relevant relationships by Kevin Bryan Lo, source=Web Response No relevant relationships by ATUL MATTA, source=Web Response No relevant relationships by Gabriel Patarroyo - Aponte, source=Web Response