An observational study of invasive mechanically ventilated critically ill SARS-CoV-2 patients
Ricardo Sanchez Garcia, Frank Hansen, Mariusz Boczan, Karsten Wiborg, Stine Hebsgaard, Emil Moser and Jakob Oxlund
Purpose: The coronavirus disease 2019 causes unique lung injury and multiorgan failure, even in young
patients without predisposed comorbidity. Our aim was to use a treatment protocol of early intubation,
light sedation, and restrictive fluid strategy, with the intention to reduce the length of stay (LOS) in the
intensive care unit (ICU) and the mortality.
Methods: This retrospective single-centre descriptive study was performed from March 10 to May 4,
2020, covering our experiences in the treatment of COVID-19 patients with respiratory failure admitted
to the ICU for mechanical ventilation. Early intubation was performed when the patient presented
hypoxemia, which no longer responded to treatment with high oxygen concentration, showing excessive
work-of-breathing and a paO2
/FiO2
ratio <200mmHg. During mechanical ventilation, non/light sedation
and restrictive fluid strategies were used.
Results: A total of 26 patients with suspected or confirmed COVID-19 were referred to our ICU. 10
patients had laboratory-confirmed RT-PCR for SARS-CoV-2 and were intubated due to hypoxemic
respiratory failure with increased work-of-breathing. The median duration of mechanical ventilation
was 5,5 days. All 10 patients were discharged from the ICU, the median length of stay in the ICU was
6,8 days. The median Richmond Agitation Scale Score was -3 on day 1 and declined to -1 on day 5. The
median cumulative fluid balance upon discharge was -374 ml.
Conclusion: Early intubation, light or nonsedation and a restrictive fluid strategy was a suitable protocol
in our limited population of mechanically ventilated, critically ill COVID-19 patients. All 10 patients
survived their COVID-19 disease.
