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The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
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Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation.
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Following publication of the original article at https://doi.org/10.1186/s13054-021-03727-x the authors identified an error in the Funding section that has been corrected (https://doi.org/10.1186/s13054-021-03849-2)
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TORRES MARTÍ, Antoni, MOTOS, Ana, RIERA, Jordi, FERNÁNDEZ BARAT, Laia, CECCATO, Adrian, PÉREZ ARNAL, Raquel, GARCÍA GASULLA, Dario, PEÑUELAS, Oscar, LORENTE, José angel, RODRIGUEZ OVIEDO, Alejandro, GONZALO CALVO, David de, MORAL PARRAS, Pedro, AGRIFOGLIO, Alexander, PIÑOL-TENA, Àngels, GARCÍA, Beatriz, MASEDA, Emilio, MENOR FERNÁNDEZ, Eva maría, VILANOVA, Judit, HUERTA, Arturo, MIRALBÉS, Mar, ÚBEDA, Alejandro, CACHAFEIRO, Lucia, ESTELLA, Ángel, PARERA POUS, Anna, CLIMENT, Cristina, YANG, Minlan, SOCIAS, Lorenzo, VILLADA WARRINGTON, Tatiana, ÁLVAREZ, Sergio, CARBAJALES PÉREZ, Cristina, MORALES, Dulce, BARBERÀ, Carme, RODRIGUEZ, Laura, ALCARAZ SERRANO, Victoria, MARIÑO, Ana balan, ALMANSA MORA, Raquel, ORTEGA, Ana, CONDE, Pamela, AGUILAR CABELLO, María, PUJOL, Andrés, RUBIO, Jorge, ÁNGEL, José, CICUENDEZ ÁVILA, Ramon, MENDOZA, Diego de, SOLIVA, Laura, MACIAS GUERRERO, Desire, RAMON COLL, Núria, RENEDO SANCHEZ-GIRON, Gloria, LOZA VÁZQUEZ, Ana, ALEGRE, Cynthia, ROCHE CAMPO, Ferran, AGUILERA, Luciano, SARIÑENA, Maria teresa, GOMÀ, Gemma, MARTÍNEZ VARELA, Ignacio, BARBETA, Enric, MARIN CORRAL, Judith, BOUZA VIEIRO, María teresa, SUARES SIPMANN, Fernando, BLANDINO ORTIZ, Aaron, SANCHO CHINESTA, Susana, CANTÓN BULNES, Maria luisa, ALBAICETA, Guillermo m., SÁNCHEZ, Ana, GÓMEZ, Silvia, BLANCAS, Rafael, TOGNETTI, Daniel, URRELO CERRÓN, Luis, BUSTAMANTE-MUNGUIRA, Juan, MENÉNDEZ, Rosario, CODINA, Jordi, CLAR, Luisa, TORMOS, Adrián, ÁLVAREZ RUIZ, Antonjo, BOFILL, Neus, TORRES, Mateu, BLASCO CORTÉS, María luisa, VENGOECHEA, Javier, MARCO NAYA, Gregorio, CARVALHO, Sula, ANDREA, Rut, BARRAL SEGADE, Patricia, MARTIN, María cruz, BARBENA, Laura, FORCELLEDO ESPINA, Lorena, BADIA, Joan ramon, VÁZQUEZ, Nil, MARMOL PEIS, Enrique, ZAPATERO, Ana, TORRE, Maria del carmen de la, FERNÁNDEZ, Javier, GÓMEZ CASAL, Vanesa, GASCÓN CASTILLO, Maria luisa, CIBERESUCICOVID PROJECT (COV20/00110, Isciii), BUENO, Leticia, ESMORÍS ARIJÓN, Inés, CARBONELL, Nieves, GÓMEZ, José m., MOSQUERA RODRÍGUEZ, David, GARCÍA, Felipe, GARCÍA GARMENDIA, José luis, IGLESIAS, Silvia, SOLÉ VIOLÁN, Jordi, SANCHEZ, Miguel, CATALÁN GONZÁLEZ, Mercedes, GALBÁN, Cristóbal, CARDINA FERNÁNDEZ, Pablo, FORCADELL FERRERES, Eva, GUMUCIO SANGUINO, Víctor d., BOADO, María, FARRE MONJO, Teresa, PEÑASCO, Yhivian, PÉREZ BASTIDA, Leire, CASACUBERTA BARBERÀ, Núria, GONZÁLEZ, Jessica, CARRIÓN GARCÍA, Laura, LEÓN, Miguel, BUSTO MARTÍNEZ, Cecilia del, GARNACHO MONTERO, José, CONTRERAS, Sofía, JUAN DÍAZ, Mar, MARCOS, Pilar, CASTRO, Pedro, LÓPEZ MESSA, Juan, PÉREZ PLANELLES, Gloria, JANER, Maria teresa, TAMAYO LOMAS, Luis, ALDECOA, César, LÓPEZ LAGO, Ana, PAGLIARANI, Pablo, BARDI, Tommaso, VARA ADRIO, Sabela, TRENADO ÁLVAREZ, José, BARBÉ, Ferran, FRANCO, Nieves, LAZO ÁLVAREZ, Juan i., ADELL SERRANO, Berta, JIMÉNEZ, Gabriel, BADÍA, Mariona, SEGURA PENSADO, Marta, MARTÍNEZ, María, FURRO, Àngels, MONTSERRAT, Neus, GRACIA, Maria pilar, PABLO SÁNCHEZ, Raul de, GÓMEZ GONZALEZ, Carmen, MUÑOZ BERMÚDEZ, Rosana, GARCÍA REDRUELLO, Carlos, AYESTARAN, Ignacio, SERRA FORTUNY, Mireia, BARROSO, Marta, BODI SAERA, María, MORA AZNAR, María, CILLÓNIZ, Catia, PÉREZ, Purificación, PARRILLA, Francisco, BEREZO GARCÍA, José ángel, LÓPEZ GAVÍN, Alexandre, MONTEJO GONZÁLEZ, Juan carlos, BIGAS, Judit, CAMPOS FERNÁNDEZ, Sandra, VIDAL CORTÉS, Pablo, NOGUERAS SALINAS, Rafaela, FERRER ROCA, Ricard, MARTÍNEZ FERNÁNDEZ, Carmen eulalia, PESTAÑA LAGUNA, David, MARTÍN VICENTE, Paula, RUIZ MIRALLES, Miriam, MAÑEZ MENDILUCE, Rafael, CAMPI HERMOSO, David, CASTELLÀ PERICÀS, Manuel, ENRÍQUEZ GIRAUDO, Pedro, RODRÍGUEZ RUIZ, Covadonga, SERRA, Lidia, BUSTAMANTE MUNGUIRA, Elena, CASTELLVÍ, Andrea, AÑÓN, José m., RODRÍGUEZ DE CASTRO, Felipe, DÍAZ, Yolanda, FIGUERAS, Albert, SALAZAR DEGRACIA, Ana, GABARRÚS, Albert, CABALLERO, Jesús, GORDO, Federico, ARRIETA RUIZ, Marta, RIVAS VILAS, María digna, DÓLERA MORENO, Cristina, NICOLÁS ARFELIS, Josep maria, RUBIO LÓPEZ, Alberto, DOT, Irene, RODRÍGUEZ, Silvia, GARCÍA SAGASTUME, Amaia, RICART, Pilar, OCÓN, Marta, SERVIÀ, Lluís, NOGUE BOU, Ramon, VALDIVIA RUIZ, Luis, PRADOS, Javier, FERRANDO, Carlos, PÉREZ RUBIO, Eva, VILÀ VILARDEL, Clara, OSSA, Sergio, GARCÍA PRIETO, Emilio, SÁNCHEZ MIRALLES, Angel, TREFLER, Sandra, HERRAIZ, Alba, KIAROSTAMI, Karsa, VAN DER HOFSTADT MARTIN-MONTALVO, Maria, NOVO, Mariana andrea, AMAYA VILLAR, Rosario, BERMEJO MARTÍN, Jesús f., HERRÁN MONGE, Rubén, RYAN MURÚA, Pablo, VAL, Estela, IBARZ, Mercedes, TRUJILLANO, Javier, MANTELLINI, Cecilia l., BÁEZ PRAVIA, Orville, YANG, Hua, SABORIDO PAZ, Eva, SPEZIALE, Carla, BARBERÁN, José, SERRANO LÁZARO, Ainhoa, JORGE GARCÍA, Ruth noemí, SANTACOLOMA, Bitor, MAMOLAR HERRERA, Nuria, BALSERA, Begoña, MARTÍNEZ JUAN, Maria dolores, MONCLOU, Josman, GALLEGO, Elena, SALVADOR ADELL, Inmaculada, POZO LADERAS, Juan carlos, MASA JIMENEZ, Juan fernando, VALLVERDÚ, Montserrat, DÍAZ SANTOS, Emili, MASCLANS, Joan ramon, MORENO CANO, Sara guadalupe, CANO, Iosune, MARTÍNEZ DE LA GÁNDARA, Amalia. The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients. _Critical Care_. 2021. Vol. 25, núm. 1. [consulta: 24 de gener de 2026]. ISSN: 1364-8535. [Disponible a: https://hdl.handle.net/2445/180518]