Table 3 Characteristics of patients according to the duration of antimicrobial treatment of the first episode
From: Recurrent ventilator-associated pneumonia in severe Covid-19 ARDS patients requiring ECMO support
Parameter | Overall population N = 210 | Duration of treatment < 8 days N = 158 | Duration of treatment ≥ 8 days N = 52 | P value |
|---|---|---|---|---|
Age, years | 51 (43–58) | 51 (43–58) | 51 (38–58) | 0.2 |
Male sex | 145 (69) | 108 (68) | 37 (71) | 0.7 |
Body mass index, kg/m2 | 32 (28–38) | 32 (28–38) | 32,5 (28–43) | 0.9 |
Comorbidities | ||||
Hypertension | 84 (40) | 66 (42) | 18 (35) | 0.4 |
Diabetes | 65 (31) | 48 (30) | 17 (33) | 0.8 |
Immunocompromised | 15 (7) | 9 (6) | 6 (12) | 0.2 |
Vaccinated against SARS CoV-2 | 5 (2) | 3 (2) | 2 (4) | 0.6 |
Admission SAPS II | 61 (52–68) | 61 (53–67) | 62 (50–71) | 0.8 |
Admission SOFA score | 12 (9–13) | 12 (9–13) | 12 (8–13) | 0.7 |
Time from first symptoms to ICU admission, days | 7 (5–10) | 8 (5–10) | 7 (4–10) | 0.4 |
Time from ICU admission to intubation, days | 3 (0–6) | 2 (0–6) | 4 (1–7) | 0.07 |
Time from intubation to ECMO, days | 4 (2–7) | 4 (2–7) | 4 (2–7) | 0.9 |
Type of ECMO support | ||||
VV | 207 (99) | 155 (98) | 52 (100) | 1.0 |
Femoro-jugular | 202 (98) | 153 (99) | 49 (94) | 0.1 |
Femoro-femoral | 5 (2) | 2 (1) | 3 (6) | 0.1 |
VA | 2 (1) | 2 (1) | 0 (0) | 1.0 |
VAV | 1 (0) | 1 (1) | 0 (0) | 1.0 |
High-flow nasal oxygen before intubation | 146 (70) | 106 (67) | 40 (77) | 0.2 |
Non-invasive ventilation before intubation | 82 (39) | 58 (37) | 24 (46) | 0.2 |
Prone-positioning before ECMO | 198 (94) | 149 (94) | 49 (94) | 1.0 |
Prone-positioning on ECMO | 169 (81) | 130 (82) | 39 (75) | 0.3 |
Immunomodulatory drugs | ||||
Tocilizumab | 19 (9) | 11 (7) | 8 (15) | 0.09 |
Dexamethasone | 158 (75) | 116 (73) | 42 (81) | 0.3 |
Number of VAP episodes | ||||
1 | 38 (18) | 30 (19) | 8 (15) | 0.6 |
2 | 48 (23) | 30 (19) | 18 (35) | 0.02 |
3 | 42 (20) | 31 (20) | 11 (21) | 0.8 |
4 | 32 (15) | 26 (17) | 6 (12) | 0.4 |
≥ 5 | 50 (24) | 41 (26) | 9 (17) | 0.2 |
Type of recurrence | ||||
Persistent infection | 55 (26) | 35 (22) | 20 (39) | 0.02 |
Relapse | 53 (25) | 39 (25) | 14 (27) | 0.7 |
Superinfection | 64 (31) | 54 (34) | 10 (19) | 0.04 |
Duration of mechanical ventilation, days | 47 (30–66) | 48 (29–67) | 47 (30–62) | 0.8 |
Ventilator-free days at day 60*, days | 0 (0–20) | 0 (0–21) | 0 (0–18) | 0.6 |
ICU length of stay, days | 53 (36–72) | 53 (37–72) | 52 (35–68) | 0.8 |
Successful ECMO weaning | 133 (63) | 103 (65) | 30 (58) | 0.3 |
ICU mortality rate | 86 (41) | 61 (39) | 25 (48) | 0.2 |