Background The surge of critically ill patients due to the coronavirus disease-2019 (COVID-19) overwhelmed critical care capacity in areas of northern Italy. Anesthesia machines have been used as alternatives to traditional ICU mechanical ventilators. However, the outcomes for patients with COVID-19 respiratory failure cared for with Anesthesia Machines is currently unknow. We hypothesized that COVID-19 patients receiving care with Anesthesia Machines would have worse outcomes compared to standard practice. Methods We designed a retrospective study of patients admitted with a confirmed COVID-19 diagnosis at a large tertiary urban hospital in northern Italy. Two care units were included: a 27-bed standard ICU and a 15-bed temporary unit emergently opened in an operating room setting. Intubated patients assigned to Anesthesia Machines (AM group) were compared to a control cohort treated with standard mechanical ventilators (ICU-VENT group). Outcomes were assessed at 60-day follow-up. A multivariable Cox regression analysis of risk factors between survivors and non-survivors was conducted to determine the adjusted risk of death for patients assigned to AM group. Results Complete daily data from 89 mechanically ventilated patients consecutively admitted to the two units were analyzed. Seventeen patients were included in the AM group, whereas 72 were in the ICU-VENT group. Disease severity and intensity of treatment were comparable between the two groups. The 60-day mortality was significantly higher in the AM group compared to the ICU-vent group (12/17 vs. 27/72, 70.6% vs. 37.5%, respectively, p = 0.016). Allocation to AM group was associated with a significantly increased risk of death after adjusting for covariates (HR 4.05, 95% CI: 1.75–9.33, p = 0.001). Several incidents and complications were reported with Anesthesia Machine care, raising safety concerns. Conclusions Our results support the hypothesis that care associated with the use of Anesthesia Machines is inadequate to provide long-term critical care to patients with COVID-19. Added safety risks must be considered if no other option is available to treat severely ill patients during the ongoing pandemic. Clinical trial number Not applicable. Supplementary Information The online version contains supplementary material available at 10.1186/s12871-021-01376-9.
【저자키워드】 COVID-19, ARDS, mechanical ventilation, intensive care unit, Anesthesia machine, 【초록키워드】 Treatment, coronavirus, pandemic, Critical care, Respiratory failure, Mortality, Trial, severity, hospital, risk, outcome, Italy, risk factor, ICU, Operating room, Retrospective study, Cohort, clinical, Patient, COVID-19 diagnosis, mechanical ventilator, Complication, Follow-up, allocation, Care, Hypothesis, Analysis, COVID-19 patient, Anesthesia, not applicable, Support, Critically ill patient, risk of death, intensity, two groups, supplementary material, treat, covariate, machine, multivariable Cox regression, survivor, mechanical ventilators, non-survivor, significantly increased, Result, analyzed, reported, conducted, receiving, treated, adjusted, determine, significantly higher, comparable, assigned, mechanically ventilated patient, patients with COVID-19, raising, severely ill patient, were assessed, 【제목키워드】 coronavirus disease, Critically ill patient,