Abstract
<b>Objective:</b> To describe and compare ventilation and outcomes in normal-weight, overweight and obese COVID-19 ARDS patients. <b>Methods:</b> Multicentre study performed in 22 ICUs in the Netherlands. Outcomes included a combination of ventilation parameters in the first 4 days, including V<sub>T</sub>, PEEP, ΔP and C<sub>RS</sub>, use of adjunctive treatments, and mortality rates. <b>Results:</b> 1122 patients were included in the study; 244 (21.3%) normal-weight patients, 531 (47.3%) overweight patients, and 324 (28.8%) obese patients. Most patients received a V<sub>T</sub> < 8 ml/kg PBW (left figure). PEEP and ΔP were higher, and C<sub>RS</sub> was lower in obese patients at all 4 days. Use of adjunctive therapies for refractory hypoxemia were not different between BMI categories. BMI category was not associated with 28–day mortality (right figure). <b>Conclusions:</b> Lung-protective ventilation with a lower V<sub>T</sub> and prone positioning is feasible in all BMI categories of COVID-19 ARDS patients. A patient’s BMI should not be used in decisions to forgo or proceed with invasive ventilation.
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