Scientific Reports (Jun 2021)
Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study
- Gianmaria Cammarota,
- Rosanna Vaschetto,
- Danila Azzolina,
- Nello De Vita,
- Carlo Olivieri,
- Chiara Ronco,
- Federico Longhini,
- Andrea Bruni,
- Davide Colombo,
- Claudio Pissaia,
- Federico Prato,
- Carlo Maestrone,
- Matteo Maestrone,
- Luigi Vetrugno,
- Tiziana Bove,
- Francesco Lemut,
- Elisa Taretto,
- Alessandro Locatelli,
- Nicoletta Barzaghi,
- Martina Cerrano,
- Enrico Ravera,
- Christian Zanza,
- Andrea Della Selva,
- Ilaria Blangetti,
- Francesco Salvo,
- Fabrizio Racca,
- Yaroslava Longhitano,
- Annalisa Boscolo,
- Ilaria Sguazzotti,
- Valeria Bonato,
- Francesca Grossi,
- Federico Crimaldi,
- Raffaella Perucca,
- Ester Boniolo,
- Federico Verdina,
- Gian Luca Vignazia,
- Erminio Santangelo,
- Riccardo Tarquini,
- Marta Zanoni,
- Antonio Messina,
- Matteo Marin,
- Paola Bacigalupo,
- Graziana Sileci,
- Nicolò Sella,
- Edardo De Robertis,
- Francesco Della Corte,
- Paolo Navalesi
Affiliations
- Gianmaria Cammarota
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia
- Rosanna Vaschetto
- Department of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”
- Danila Azzolina
- Translational Medicine Department, Università “del Piemonte Orientale”
- Nello De Vita
- Translational Medicine Department, Università “del Piemonte Orientale”
- Carlo Olivieri
- Anesthesia and Intensive Care, Ospedale Sant’Andrea”
- Chiara Ronco
- Anesthesia and Intensive Care, Ospedale Sant’Andrea”
- Federico Longhini
- Department of Medical and Surgical Science, Università “Magna Graecia”
- Andrea Bruni
- Department of Medical and Surgical Science, Università “Magna Graecia”
- Davide Colombo
- Department of Anesthesia and Critical Care, Ospedale “Ss. Trinità”
- Claudio Pissaia
- Department of Anesthesia and Critical Care, Ospedale “degli Infermi”
- Federico Prato
- Department of Anesthesia and Critical Care, Ospedale “degli Infermi”
- Carlo Maestrone
- Department of Anesthesia and Critical Care, Presidio Ospedaliero Domodossola e Verbania “ASL VCO”
- Matteo Maestrone
- Department of Anesthesia and Critical Care, Presidio Ospedaliero Domodossola e Verbania “ASL VCO”
- Luigi Vetrugno
- Department of Medicine, Anesthesia and Intensive Care Clinic, Università di Udine
- Tiziana Bove
- Department of Medicine, Anesthesia and Intensive Care Clinic, Università di Udine
- Francesco Lemut
- Department of Anesthesia and Critical Care, Ospedale “Monsignor Giovanni Galliano”
- Elisa Taretto
- Department of Anesthesia and Critical Care, Ospedale “Monsignor Giovanni Galliano”
- Alessandro Locatelli
- Department of Anesthesia and Critical Care, Azienda Ospedaliera “Santa Croce e Carle”
- Nicoletta Barzaghi
- Department of Anesthesia and Critical Care, Azienda Ospedaliera “Santa Croce e Carle”
- Martina Cerrano
- Department of Anesthesia and Critical Care, Azienda Ospedaliera “Santa Croce e Carle”
- Enrico Ravera
- Department of Emergency Medicine-Anesthesia and Critical Care-Michele, Pietro Ferrero Hospital
- Christian Zanza
- Department of Emergency Medicine-Anesthesia and Critical Care-Michele, Pietro Ferrero Hospital
- Andrea Della Selva
- Department of Emergency Medicine-Anesthesia and Critical Care-Michele, Pietro Ferrero Hospital
- Ilaria Blangetti
- Department of Anesthesia and Intensive Care, Ospedale “Regina Montis Regalis”
- Francesco Salvo
- Department of Anesthesia and Intensive Care, Ospedale “Regina Montis Regalis”
- Fabrizio Racca
- Department of Anesthesia and Intensive Care, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo
- Yaroslava Longhitano
- Department of Anesthesia and Intensive Care, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo
- Annalisa Boscolo
- Anesthesia and Intensive Care Unit, Ospedale Universitario di Padova
- Ilaria Sguazzotti
- Department of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”
- Valeria Bonato
- Department of Anesthesia and Intensive Care, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo
- Francesca Grossi
- Department of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”
- Federico Crimaldi
- Translational Medicine Department, Università “del Piemonte Orientale”
- Raffaella Perucca
- Department of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”
- Ester Boniolo
- Translational Medicine Department, Università “del Piemonte Orientale”
- Federico Verdina
- Translational Medicine Department, Università “del Piemonte Orientale”
- Gian Luca Vignazia
- Department of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”
- Erminio Santangelo
- Translational Medicine Department, Università “del Piemonte Orientale”
- Riccardo Tarquini
- Translational Medicine Department, Università “del Piemonte Orientale”
- Marta Zanoni
- Department of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”
- Antonio Messina
- Humanitas, Clinical and Research Center – IRCCS
- Matteo Marin
- Department of Medicine, Anesthesia and Intensive Care Clinic, Università di Udine
- Paola Bacigalupo
- Department of Anesthesia and Critical Care, Ospedale “Monsignor Giovanni Galliano”
- Graziana Sileci
- Department of Anesthesia and Critical Care, Ospedale “Monsignor Giovanni Galliano”
- Nicolò Sella
- Department of Medicine-DIMED, Università di Padova
- Edardo De Robertis
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia
- Francesco Della Corte
- Department of Anesthesia and Intensive Care, AAzienda Ospedaliero Universitaria “Maggiore della Carità”
- Paolo Navalesi
- Anesthesia and Intensive Care Unit, Ospedale Universitario di Padova
- DOI
- https://doi.org/10.1038/s41598-021-92960-z
- Journal volume & issue
-
Vol. 11,
no. 1
pp. 1 – 9
Abstract
Abstract In patients intubated for hypoxemic acute respiratory failure (ARF) related to novel coronavirus disease (COVID-19), we retrospectively compared two weaning strategies, early extubation with immediate non-invasive ventilation (NIV) versus standard weaning encompassing spontaneous breathing trial (SBT), with respect to IMV duration (primary endpoint), extubation failures and reintubations, rate of tracheostomy, intensive care unit (ICU) length of stay and mortality (additional endpoints). All COVID-19 adult patients, intubated for hypoxemic ARF and subsequently extubated, were enrolled. Patients were included in two groups, early extubation followed by immediate NIV application, and conventionally weaning after passing SBT. 121 patients were enrolled and analyzed, 66 early extubated and 55 conventionally weaned after passing an SBT. IMV duration was 9 [6–11] days in early extubated patients versus 11 [6–15] days in standard weaning group (p = 0.034). Extubation failures [12 (18.2%) vs. 25 (45.5%), p = 0.002] and reintubations [12 (18.2%) vs. 22 (40.0%) p = 0.009] were fewer in early extubation compared to the standard weaning groups, respectively. Rate of tracheostomy, ICU mortality, and ICU length of stay were no different between groups. Compared to standard weaning, early extubation followed by immediate NIV shortened IMV duration and reduced the rate of extubation failure and reintubation.
