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Risk Factors for Weaning Failure in COVID-19 Patients

Effrosyni Gerovasileiou
Effrosyni Gerovasileiou
, 
Apostolis-Alkiviadis Menis
Apostolis-Alkiviadis Menis
, 
George Gavriilidis
George Gavriilidis
, 
Eleni Magira
Eleni Magira
, 
Prodromos Temperikidis
Prodromos Temperikidis
, 
Sofia Papoti
Sofia Papoti
, 
Nikitas Karavidas
Nikitas Karavidas
, 
Michael Spanos
Michael Spanos
, 
Epaminondas Zakynthinos
Epaminondas Zakynthinos
 y 
Demosthenes Makris
Demosthenes Makris
   | 31 jul 2023
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Article Category: Research Article
Publicado en línea: 31 jul 2023
Páginas: 170 - 177
Recibido: 22 oct 2022
Aceptado: 21 jul 2023
DOI: https://doi.org/10.2478/jccm-2023-0021
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© 2023 Effrosyni Gerovasileiou et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Characteristics of participants according to weaning outcome.

Weaning Success (N=61) Weaning Failure (N=97) P Value
Age, years 62.39 (59.1–65.66) 67.41 (65.22–69.61) 0.02
Men, n (%) 42 (68.9) 61 (62.96) 0.49
APACHE II score Day 0 14.87 (13.46–16.28) 16.46 (15.19–17.72) 0.12
SOFA score Day 0 7.2 (6.67–7.75) 8.24 (7.70–8.77) 0.02
Heart failure, n (%) 4 (6.5) 18 (18.5) 0.03
Diabetes mellitus, n (%) 13 (21.3) 14 (14.4) 0.28
Hypertension, n (%) 31 (50.8) 46 (47.4) 0.74
COPD, n (%) 4 (6.5) 20 (20.6) 0.02
Immunosuppression, n (%) 2 (3.2) 12 (12.3) 0.08
Corticosteroids, mg/Kg/Daya 0.95 (0.65–1.26) 0.93 (0.69–1.18) 0.66
PO2/FiO2, mmHg 142.9 (123.2–162.5) 124.9 (97.89–151.9) 0.25
Mechanical ventilation duration, days 7.6 (6.1–9.07) 12.9 (11.06–14.73) <0.0001
Vt ml/Kgb 5.80 (5.30–6.30) 6.26 (6.02–6.51) 0.058
Pplat, ICU Day 0, cmH2O 22.85 (21.52–24.18) 25.28 (23.89–26.66) 0.04
Driving Pressure, ICU Day 0, cm H2O 11.1 (10.3–11.9) 13.02 (11.84–14.21) 0.03
PEEP ICU Day 0, cmH2O 10.54 (9.65–11.42) 10.21 (9.52–10.90) 0.38
PEEP >12 cmH2O (Day 0–7), hours 43.53 (28.02–59.03) 55.11 (41.30–68.92) 0.28
Fluid Balance ICU Days 0–7, lit 3.44 (1.17–5.71) 6.17 (4.2–8.13) 0.04
SARS-CoV-2 pneumonia, n (%) 42 (68.8) 54 (55.7) 0.13
Temperature >38.5 °C, hours 21.34 (10.99–31.70) 28.19 (16.70–39.69) 0.56
VAP, n (%) 29 (47.5) 33 (34) 0.09
VAPc 153 (17.31) 191 (21.61) <0.0001
BSI, n (%) 22 (36) 46 (47.4) 0.18
BSId 116 (13.11) 266 (30.06) 0.001
Shock, n (%) 20 (32.7) 59 (60.8) 0.001
Septic – VAP, n (%) 4 (20) 5 (8.5)
Septic – BSI, n (%) 6 (30) 16 (27.1)
Septic – VAP&BSI, n (%) 6 (30) 15 (25.4)
Unclear*, n (%) 3 (15) 24 (40.7)
ICU antibiotics course, dayse 18.56 (15.78–21.34) 16.55 (14.25–18.84) 0.13
ICU mortality 28th day, n (%) 6 (9.8) 67 (69) <0.0001
ICU length of stay, days 18.87 (16.17–21.56) 17.25 (14.89–19.61) 0.12

Characteristics of SARS-CoV2 ARDS patients according to weaning outcome.

Weaning Success (N=42) Weaning Failure (N=54) P Value
Age, years 61.26 (57.12–65.41) 68.98 (65.89–72.08) 0.003
Men, n (%) 28(66.7) 33(61.1) 0.67
APACHE II score ICU Day 0 14.38 (12.95–15.81) 15.69 (14.34–17.03) 0.15
SOFA score ICU Day 0 7.4 (6.80–8.09) 8.2 (7.56–8.84) 0.16
Heart failure, n (%) 2 (4.7) 7 (12.3) 0.29
Diabetes mellitus, n (%) 9 (21.4) 17 (31.5) 0.35
Hypertension, n (%) 20 (47.6) 27 (50) 0.84
COPD, n (%) 2 (4.8) 11 (20.4) 0.03
Immunosuppression, n (%) 0 (0.0) 6 (11.1) 0.03
Corticosteroids, mg/kg/Daya 1.13 (0.77–1.49) 1.43 (1.07–1.80) 0.29
PO2/FiO2, mmHg 148.9 (123.8–174) 106.1 (75.68–136.5) 0.02
Mechanical ventilation duration, days 7.59 (5.91–9.27) 11.56 (9.17–13.92) 0.006
Vt ml/Kgb 5.80 (5.27–6.34) 6.39 (6.18–6.11) 0.13
Pplat, ICU Day 0, cmH2O 22.67 (21.23–24.1) 25.37 (23.91–26.88) 0.016
Driving Pressure, ICU Day 0, cm H2O 10.92 (10.11–11.72) 13.02 (11.84–14.21) 0.017
PEEP ICU Day 0, cmH2O 11.45 (10.39–12.51) 11.94 (11.13–12.76) 0.63
PEEP >12 cmH2O (Day 0–7), hours 61.5 (41.83–81.17) 82.17 (62.55–101.7) 0.11
Fluid Balance ICU Days 0–7, lit 2.71 (−0.1–5.51) 3.74 (1.17–5.80) 0.3
Temperature >38.5°C, hours 22.36 (10.88–33.83) 14.56 (4.61–24.50) 0.14
VAP, n (%) 22 (53.6) 15 (27.8) 0.01
VAPc 126 (19.35) 110 (16.90) <0.0001
BSI, n (%) 15 (36.6) 25 (46.3) 0.4
BSId 86 (13.23) 183 (28.15) 0.02
Shock, n (%) 12 (29.2) 39 (72.2) <0.0001
VAP, n (%) 3 (25) 4 (10.2)
BSI, n (%) 2 (16.6) 11 (28.2)
VAP and BSI, n (%) 5 (41.6) 8 (20.5)
Unclear*, n (%) 2 (16.6) 15 (38.4)
ICU antibiotics course, dayse 16.5 (13.86–19.14) 13.13 (10.60–15.66) 0.02
ICU mortality 28th day, n (%) 4 (9.7) 42 (77.8) <0.0001
ICU length of stay, days 17.44 (14.87–20) 13.65 (11.18–16.12) 0.01

Results of binary regression analyses of risk factors associated with weaning success in SARS-CoV2 ARDS patients and ARDS patients

Variables S.E P value O.R Lower 95% C.I Upper 95% C.I
SARS-CoV2 ARDS
COPD 0.85 0.04 0.18 0.03 0.96
SOFA score 0.11 0.17 0.86 0.69 1.06
Shock 0.49 0.02 0.33 0.12 0.86
ARDS
COPD 0.86 0.36 0.46 0.08 2.44
SOFA score 0.11 0.07 0.82 0.66 1.01
Shock 0.59 0.71 0.8 0.25 2.55

Results of binary regression analysis of risk factors associated with weaning success in the total population

Variables S.E P value O.R Lower 95%C.I Upper 95% C.I
COPD 0.61 0.03 0.27 0.08 0.89
SOFA score 0.08 0.04 0.86 0.73 0.99
Shock 0.37 0.001 0.3 0.14 0.61
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