Abstract
Purpose: To compare the effects of two therapeutic bundles of management in SARS-CoV2 ICU patients.
Materials and methods: Our retrospective, observational study was performed in a university ICU from March to June 2020 (first wave) and from September 2020 to January 2021 (second wave). In first wave, patients received bundle 1 including early invasive ventilation, hydroxychloroquine, cefotaxime and azithromycin. In second wave, bundle 2 included non-invasive oxygenation support and dexamethasone. The main outcome was in-hospital mortality. Secondary outcomes included ICU and hospital length of stay, ICU supportive therapies, viral clearance and antimicrobial resistance emergence.
Results: 129 patients with SARS-CoV-2 pneumonia were admitted to our ICU. Thirty-five were treated according to bundle 1 and 76 to bundle 2. In-hospital mortality was similar in the two groups (23%, p = 1). The hospital (p = 0.003) and ICU (p = 0.01) length of stay and ventilator-free days at 28 days (p = 0.03) were significantly reduced in bundle 2. Increasing age, vasopressor use and PaO 2 /FiO 2 ratio < 125 were associated with in-hospital mortality.
Conclusion: Within the limitations of our study, changes in therapeutic bundles for SARS-Cov-2 ICU patients might have no effect on in-hospital mortality but were associated with less exposure to mechanical ventilation and reduced hospital length of stay.
Keywords: Bundle; COVID-19; Dexamethasone; Hydroxychloroquine; Intensive care unit; Treatment.
【저자키워드】 COVID-19, Dexamethasone, Treatment, Hydroxychloroquine, intensive care unit, Bundle, 【초록키워드】 SARS-CoV2, Mortality, mechanical ventilation, Pneumonia, hospital, outcome, invasive ventilation, viral clearance, ICU, management, therapeutic, Patient, second wave, age, ICU Patients, First wave, Care, in-hospital mortality, retrospective, Oxygenation, supportive therapies, Support, Non-invasive, limitation, material, Effect, secondary, ICU patient, significantly, was performed, reduced, treated, less, changes in, two group, Increasing, PaO, patients with SARS-CoV-2, ventilator-free day, 【제목키워드】 intensive care, Retrospective study, SARS-CoV-2 pneumonia,