Use of low tidal volume ventilation (LTVV) has an association with outcome in COVID-19 patients

Abstract

<b>Introduction:</b> Use of LTVV benefits patients with ARDS. It is uncertain how well LTVV is used in COVID-19 ARDS patients, and whether its use is associated with outcome. <b>Aim:</b> To ascertain the use of LTVV in COVID-19 ARDS patients, and its association with several outcome measures. <b>Methods:</b> Multicenter observational study in 22 ICUs in the Netherlands. Endpoints were the proportion of patients receiving LTVV, defined as a median tidal volume (V_T) ≤ 6 ml/kg predicted bodyweight (PBW) during assist ventilation (primary), mortality rates, duration of ventilation and ICU and hospital LOS. <b>Results:</b> Of 839 COVID-19 ARDS patients, 280 (33%) patients received LTVV. ARDS severity and SOFA scores were not different between patients who received LTVV and those who did not. LTVV patients had a lower ICU (27 vs 37%) and 90-day mortality (32 vs 41%) (Fig A) and shorter duration of ventilation (15 [10-29] vs 16 [9-28] days); mean number of ventilator-free days at day 28 (8.3 ± 8.8 vs 7.2 ± 8.7 days, <i>P</i> &lt; 0.85) and ICU (16 [10-29] vs 18 [11-30] days) and hospital LOS (29 [19-44] vs 30 [20-44] days) in survivors was similar (Fig B-D). <b>Conclusions:</b> One-third of COVID-19 ARDS patients receive LTVV, which has an association with a lower mortality.