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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

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01-02-2021 | Acute Respiratory Distress-Syndrome | Reports of Original Investigations

Early experience with critically ill patients with COVID-19 in Montreal

Authors: Yiorgos Alexandros Cavayas, MD, MSc, Alexandre Noël, MD, Veronique Brunette, MD, David Williamson, BPharm, PhD, Anne Julie Frenette, PharmD, PhD, Christine Arsenault, MD, Patrick Bellemare, MD, Colin Lagrenade-Verdant, MD, Soazig LeGuillan, MD, Emilie Levesque, MD, Yoan Lamarche, MD, Marc Giasson, MD, Philippe Rico, MD, Yanick Beaulieu, MD, Pierre Marsolais, MD, Karim Serri, MD, Francis Bernard, MD, Martin Albert, MD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 2/2021

Abstract

Purpose

Montreal has been the epicentre of the coronavirus disease (COVID-19) pandemic in Canada. Given the regional disparities in incidence and mortality in the general population, we aimed to describe local characteristics, treatments, and outcomes of critically ill COVID-19 patients in Montreal.

Methods

A single-centre retrospective cohort of consecutive adult patients admitted to the intensive care unit (ICU) of Hôpital du Sacré-Coeur de Montréal with confirmed COVID-19 were included.

Results

Between 20 March and 13 May 2020, 75 patients were admitted, with a median [interquartile range (IQR)] age of 62 [53–72] yr and high rates of obesity (47%), hypertension (67%), and diabetes (37%). Healthcare-related infections were responsible for 35% of cases. The median [IQR] day 1 sequential organ failure assessment score was 6 [3–7]. Invasive mechanical ventilation (IMV) was used in 57% of patients for a median [IQR] of 11 [5–22] days. Patients receiving IMV were characterized by a moderately decreased median [IQR] partial pressure of oxygen:fraction of inspired oxygen (day 1 PaO₂:F_iO₂ = 177 [138–276]; day 10 = 173 [147–227]) and compliance (day 1 = 48 [38–58] mL/cmH₂O; day 10 = 34 [28–42] mL/cmH₂O) and very elevated estimated dead space fraction (day 1 = 0.60 [0.53–0.67]; day 10 = 0.72 [0.69–0.79]). Overall hospital mortality was 25%, and 21% in the IMV patients. Mortality was 82% in patients ≥ 80 yr old.

Conclusions

Characteristics and outcomes of critically ill patients with COVID-19 in Montreal were similar to those reported in the existing literature. We found an increased physiologic dead space, supporting the hypothesis that pulmonary vascular injury may be central to COVID-19-induced lung damage.

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Title: Early experience with critically ill patients with COVID-19 in Montreal
Authors: Yiorgos Alexandros Cavayas, MD, MSc
Alexandre Noël, MD
Veronique Brunette, MD
David Williamson, BPharm, PhD
Anne Julie Frenette, PharmD, PhD
Christine Arsenault, MD
Patrick Bellemare, MD
Colin Lagrenade-Verdant, MD
Soazig LeGuillan, MD
Emilie Levesque, MD
Yoan Lamarche, MD
Marc Giasson, MD
Philippe Rico, MD
Yanick Beaulieu, MD
Pierre Marsolais, MD
Karim Serri, MD
Francis Bernard, MD
Martin Albert, MD
Publication date: 01-02-2021
Publisher: Springer International Publishing
Keywords: Acute Respiratory Distress-Syndrome
COVID-19
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 2/2021
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-020-01816-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Early experience with critically ill patients with COVID-19 in Montreal

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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