Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study

Gianmaria Cammarota; Rosanna Vaschetto; Danila Azzolina; Nello De Vita; Carlo Olivieri; Chiara Ronco; Federico Longhini; Andrea Bruni; Davide Colombo; Claudio Pissaia; Federico Prato; Carlo Maestrone; Matteo Maestrone; Luigi Vetrugno; Tiziana Bove; Francesco Lemut; Elisa Taretto; Alessandro Locatelli; Nicoletta Barzaghi; Martina Cerrano; Enrico Ravera; Christian Zanza; Andrea Della Selva; Ilaria Blangetti; Francesco Salvo; Fabrizio Racca; Yaroslava Longhitano; Annalisa Boscolo; Ilaria Sguazzotti; Valeria Bonato; Francesca Grossi; Federico Crimaldi; Raffaella Perucca; Ester Boniolo; Federico Verdina; Gian Luca Vignazia; Erminio Santangelo; Riccardo Tarquini; Marta Zanoni; Antonio Messina; Matteo Marin; Paola Bacigalupo; Graziana Sileci; Nicolò Sella; Edardo De Robertis; Francesco Della Corte; Paolo Navalesi

doi:10.1038/s41598-021-92960-z

Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study

Gianmaria Cammarota
, Rosanna Vaschetto
, Danila Azzolina
, Nello De Vita
, Carlo Olivieri
, Chiara Ronco
, Federico Longhini
, Andrea Bruni
, Davide Colombo
, Claudio Pissaia
, Federico Prato
, Carlo Maestrone
, Matteo Maestrone
, Luigi Vetrugno
, Tiziana Bove
, Francesco Lemut
, Elisa Taretto
, Alessandro Locatelli
, Nicoletta Barzaghi
, Martina Cerrano

Enrico Ravera, Christian Zanza, Andrea Della Selva, Ilaria Blangetti, Francesco Salvo, Fabrizio Racca, Yaroslava Longhitano, Annalisa Boscolo, Ilaria Sguazzotti, Valeria Bonato, Francesca Grossi, Federico Crimaldi, Raffaella Perucca, Ester Boniolo, Federico Verdina, Gian Luca Vignazia, Erminio Santangelo, Riccardo Tarquini, Marta Zanoni, Antonio Messina, Matteo Marin, Paola Bacigalupo, Graziana Sileci, Nicolò Sella, Edardo De Robertis, Francesco Della Corte, Paolo Navalesi

Department of Translational Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

In patients intubated for hypoxemic acute respiratory failure (ARF) related to novel coronavirus disease (COVID-19), we retrospectively compared two weaning strategies, early extubation with immediate non-invasive ventilation (NIV) versus standard weaning encompassing spontaneous breathing trial (SBT), with respect to IMV duration (primary endpoint), extubation failures and reintubations, rate of tracheostomy, intensive care unit (ICU) length of stay and mortality (additional endpoints). All COVID-19 adult patients, intubated for hypoxemic ARF and subsequently extubated, were enrolled. Patients were included in two groups, early extubation followed by immediate NIV application, and conventionally weaning after passing SBT. 121 patients were enrolled and analyzed, 66 early extubated and 55 conventionally weaned after passing an SBT. IMV duration was 9 [6–11] days in early extubated patients versus 11 [6–15] days in standard weaning group (p = 0.034). Extubation failures [12 (18.2%) vs. 25 (45.5%), p = 0.002] and reintubations [12 (18.2%) vs. 22 (40.0%) p = 0.009] were fewer in early extubation compared to the standard weaning groups, respectively. Rate of tracheostomy, ICU mortality, and ICU length of stay were no different between groups. Compared to standard weaning, early extubation followed by immediate NIV shortened IMV duration and reduced the rate of extubation failure and reintubation.

Original language	English
Article number	13418
Journal	Scientific Reports
Volume	11
Issue number	1
DOIs	https://doi.org/10.1038/s41598-021-92960-z
Publication status	Published - Dec 2021

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Cammarota, G., Vaschetto, R., Azzolina, D., De Vita, N., Olivieri, C., Ronco, C., Longhini, F., Bruni, A., Colombo, D., Pissaia, C., Prato, F., Maestrone, C., Maestrone, M., Vetrugno, L., Bove, T., Lemut, F., Taretto, E., Locatelli, A., Barzaghi, N., ... Navalesi, P. (2021). Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study. Scientific Reports, 11(1), Article 13418. https://doi.org/10.1038/s41598-021-92960-z

@article{176bb346fcb44625813165333971aa26,

title = "Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study",

abstract = "In patients intubated for hypoxemic acute respiratory failure (ARF) related to novel coronavirus disease (COVID-19), we retrospectively compared two weaning strategies, early extubation with immediate non-invasive ventilation (NIV) versus standard weaning encompassing spontaneous breathing trial (SBT), with respect to IMV duration (primary endpoint), extubation failures and reintubations, rate of tracheostomy, intensive care unit (ICU) length of stay and mortality (additional endpoints). All COVID-19 adult patients, intubated for hypoxemic ARF and subsequently extubated, were enrolled. Patients were included in two groups, early extubation followed by immediate NIV application, and conventionally weaning after passing SBT. 121 patients were enrolled and analyzed, 66 early extubated and 55 conventionally weaned after passing an SBT. IMV duration was 9 [6–11] days in early extubated patients versus 11 [6–15] days in standard weaning group (p = 0.034). Extubation failures [12 (18.2\%) vs. 25 (45.5\%), p = 0.002] and reintubations [12 (18.2\%) vs. 22 (40.0\%) p = 0.009] were fewer in early extubation compared to the standard weaning groups, respectively. Rate of tracheostomy, ICU mortality, and ICU length of stay were no different between groups. Compared to standard weaning, early extubation followed by immediate NIV shortened IMV duration and reduced the rate of extubation failure and reintubation.",

author = "Gianmaria Cammarota and Rosanna Vaschetto and Danila Azzolina and \{De Vita\}, Nello and Carlo Olivieri and Chiara Ronco and Federico Longhini and Andrea Bruni and Davide Colombo and Claudio Pissaia and Federico Prato and Carlo Maestrone and Matteo Maestrone and Luigi Vetrugno and Tiziana Bove and Francesco Lemut and Elisa Taretto and Alessandro Locatelli and Nicoletta Barzaghi and Martina Cerrano and Enrico Ravera and Christian Zanza and Selva, \{Andrea Della\} and Ilaria Blangetti and Francesco Salvo and Fabrizio Racca and Yaroslava Longhitano and Annalisa Boscolo and Ilaria Sguazzotti and Valeria Bonato and Francesca Grossi and Federico Crimaldi and Raffaella Perucca and Ester Boniolo and Federico Verdina and Vignazia, \{Gian Luca\} and Erminio Santangelo and Riccardo Tarquini and Marta Zanoni and Antonio Messina and Matteo Marin and Paola Bacigalupo and Graziana Sileci and Nicol{\`o} Sella and \{De Robertis\}, Edardo and Corte, \{Francesco Della\} and Paolo Navalesi",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = dec,

doi = "10.1038/s41598-021-92960-z",

language = "English",

volume = "11",

journal = "Scientific Reports",

issn = "2045-2322",

publisher = "Nature Research",

number = "1",

}

Cammarota, G , Vaschetto, R, Azzolina, D, De Vita, N, Olivieri, C, Ronco, C, Longhini, F, Bruni, A, Colombo, D, Pissaia, C, Prato, F, Maestrone, C, Maestrone, M, Vetrugno, L, Bove, T, Lemut, F, Taretto, E, Locatelli, A, Barzaghi, N, Cerrano, M, Ravera, E, Zanza, C, Selva, AD, Blangetti, I, Salvo, F, Racca, F, Longhitano, Y, Boscolo, A, Sguazzotti, I, Bonato, V, Grossi, F, Crimaldi, F, Perucca, R, Boniolo, E, Verdina, F, Vignazia, GL, Santangelo, E, Tarquini, R, Zanoni, M, Messina, A, Marin, M, Bacigalupo, P, Sileci, G, Sella, N, De Robertis, E, Corte, FD & Navalesi, P 2021, 'Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study', Scientific Reports, vol. 11, no. 1, 13418. https://doi.org/10.1038/s41598-021-92960-z

TY - JOUR

T1 - Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019

T2 - a retrospective multicenter study

AU - Cammarota, Gianmaria

AU - Vaschetto, Rosanna

AU - Azzolina, Danila

AU - De Vita, Nello

AU - Olivieri, Carlo

AU - Ronco, Chiara

AU - Longhini, Federico

AU - Bruni, Andrea

AU - Colombo, Davide

AU - Pissaia, Claudio

AU - Prato, Federico

AU - Maestrone, Carlo

AU - Maestrone, Matteo

AU - Vetrugno, Luigi

AU - Bove, Tiziana

AU - Lemut, Francesco

AU - Taretto, Elisa

AU - Locatelli, Alessandro

AU - Barzaghi, Nicoletta

AU - Cerrano, Martina

AU - Ravera, Enrico

AU - Zanza, Christian

AU - Selva, Andrea Della

AU - Blangetti, Ilaria

AU - Salvo, Francesco

AU - Racca, Fabrizio

AU - Longhitano, Yaroslava

AU - Boscolo, Annalisa

AU - Sguazzotti, Ilaria

AU - Bonato, Valeria

AU - Grossi, Francesca

AU - Crimaldi, Federico

AU - Perucca, Raffaella

AU - Boniolo, Ester

AU - Verdina, Federico

AU - Vignazia, Gian Luca

AU - Santangelo, Erminio

AU - Tarquini, Riccardo

AU - Zanoni, Marta

AU - Messina, Antonio

AU - Marin, Matteo

AU - Bacigalupo, Paola

AU - Sileci, Graziana

AU - Sella, Nicolò

AU - De Robertis, Edardo

AU - Corte, Francesco Della

AU - Navalesi, Paolo

PY - 2021/12

Y1 - 2021/12

N2 - In patients intubated for hypoxemic acute respiratory failure (ARF) related to novel coronavirus disease (COVID-19), we retrospectively compared two weaning strategies, early extubation with immediate non-invasive ventilation (NIV) versus standard weaning encompassing spontaneous breathing trial (SBT), with respect to IMV duration (primary endpoint), extubation failures and reintubations, rate of tracheostomy, intensive care unit (ICU) length of stay and mortality (additional endpoints). All COVID-19 adult patients, intubated for hypoxemic ARF and subsequently extubated, were enrolled. Patients were included in two groups, early extubation followed by immediate NIV application, and conventionally weaning after passing SBT. 121 patients were enrolled and analyzed, 66 early extubated and 55 conventionally weaned after passing an SBT. IMV duration was 9 [6–11] days in early extubated patients versus 11 [6–15] days in standard weaning group (p = 0.034). Extubation failures [12 (18.2%) vs. 25 (45.5%), p = 0.002] and reintubations [12 (18.2%) vs. 22 (40.0%) p = 0.009] were fewer in early extubation compared to the standard weaning groups, respectively. Rate of tracheostomy, ICU mortality, and ICU length of stay were no different between groups. Compared to standard weaning, early extubation followed by immediate NIV shortened IMV duration and reduced the rate of extubation failure and reintubation.

AB - In patients intubated for hypoxemic acute respiratory failure (ARF) related to novel coronavirus disease (COVID-19), we retrospectively compared two weaning strategies, early extubation with immediate non-invasive ventilation (NIV) versus standard weaning encompassing spontaneous breathing trial (SBT), with respect to IMV duration (primary endpoint), extubation failures and reintubations, rate of tracheostomy, intensive care unit (ICU) length of stay and mortality (additional endpoints). All COVID-19 adult patients, intubated for hypoxemic ARF and subsequently extubated, were enrolled. Patients were included in two groups, early extubation followed by immediate NIV application, and conventionally weaning after passing SBT. 121 patients were enrolled and analyzed, 66 early extubated and 55 conventionally weaned after passing an SBT. IMV duration was 9 [6–11] days in early extubated patients versus 11 [6–15] days in standard weaning group (p = 0.034). Extubation failures [12 (18.2%) vs. 25 (45.5%), p = 0.002] and reintubations [12 (18.2%) vs. 22 (40.0%) p = 0.009] were fewer in early extubation compared to the standard weaning groups, respectively. Rate of tracheostomy, ICU mortality, and ICU length of stay were no different between groups. Compared to standard weaning, early extubation followed by immediate NIV shortened IMV duration and reduced the rate of extubation failure and reintubation.

UR - https://www.scopus.com/pages/publications/85109691183

U2 - 10.1038/s41598-021-92960-z

DO - 10.1038/s41598-021-92960-z

M3 - Article

SN - 2045-2322

VL - 11

JO - Scientific Reports

JF - Scientific Reports

IS - 1

M1 - 13418

ER -

Early extubation with immediate non-invasive ventilation versus standard weaning in intubated patients for coronavirus disease 2019: a retrospective multicenter study

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