Invasive mechanical ventilation strategies, adjuvants treatments and adverse events among ICU patients with COVID-19 in Denmark

Martine S Nielsen; Ulrich Halekoh; Anders Perner; Trine Haberlandt; Nikolai Arnold- Larsen; Sarah Weihe; Ricardo S Garcia; Hanna Siegel; Christian Hagdrup; Mads R Skøtt; Anne-Mette S Jensen; Jonathan B Frische; Kasper Wethelund; Søren H Christiansen; Søren R Aagaard; Sofie Højlund; Bo Westergaard; Aage Christiansen; George Michagin; Marie S Worm; Ann-Kristine M Svendsen; Kirstine N la Cour; Trine B Jonassen; Jens U Jensen; Kasper M Sørensen; Nicolai Haase; Bodil S Rasmussen; Anne C Brøchner

doi:10.1111/aas.14571

Invasive mechanical ventilation strategies, adjuvants treatments and adverse events among ICU patients with COVID-19 in Denmark

Martine S Nielsen
, Ulrich Halekoh
, Anders Perner
, Trine Haberlandt
, Nikolai Arnold- Larsen
, Sarah Weihe
, Ricardo S Garcia
, Hanna Siegel
, Christian Hagdrup
, Mads R Skøtt
, Anne-Mette S Jensen
, Jonathan B Frische
, Kasper Wethelund
, Søren H Christiansen
, Søren R Aagaard
, Sofie Højlund
, Bo Westergaard
, Aage Christiansen
, George Michagin
, Marie S Worm

Ann-Kristine M Svendsen, Kirstine N la Cour, Trine B Jonassen, Jens U Jensen, Kasper M Sørensen, Nicolai Haase, Bodil S Rasmussen, Anne C Brøchner^*

^*Corresponding author for this work

Anaesthesiology

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

Abstract

AIM: To describe the use of invasive mechanical ventilation core strategies, adjuvant treatments and the occurrence of barotrauma and prolonged ventilation in ICU patients with COVID-19 in Denmark, retrospectively.

METHODS: All ICUs admitting COVID-19 patients in Denmark from 10 March 2020 to 2 April 2021 were invited to participate. All patients with COVID-19 who received invasive mechanical ventilation were included and data was retrospectively collected from electronic patient records.

RESULTS: A total of 774 patients were invasively ventilated during the first two waves and included; 70% were males and the median age was 69 years. 340 (51.5%) of patients never exceeded tidal volumes of 8 mL/kg. For all patients, tidal volumes under 8 mL/kg were applied in 77.6% (IQR 54.5%-96.2%) of the time on ventilator in the ICU; plateau pressure was below 30 cm H2O in 125 (80.6%) patients; prone positioning was used in 44.7% of patients. In ICU, 169 of 774 (21.8%) patients experienced barotrauma and 220 (28.4%) prolonged ventilation. At 90 days, 306 (39.5%) had died.

CONCLUSIONS: Lung protective ventilation and prone positioning were used in many of the Danish ICU patients with COVID-19, but barotrauma, prolonged ventilation and death occurred frequently.

Original language	English
Article number	e14571
Number of pages	9
Journal	Acta Anaesthesiologica Scandinavica
Volume	69
Issue number	2
DOIs	https://doi.org/10.1111/aas.14571
Publication status	Published - Feb 2025

Keywords

Humans
COVID-19/therapy
Male
Denmark/epidemiology
Female
Respiration, Artificial
Aged
Retrospective Studies
Middle Aged
Intensive Care Units
Barotrauma/etiology
Tidal Volume
Prone Position
Aged, 80 and over
Critical Care/methods
Core strategies
Covid-19
Adverse events
Mechanical ventilation
Barotrauma

Access to Document

10.1111/aas.14571

Cite this

Nielsen, M. S., Halekoh, U., Perner, A., Haberlandt, T., Larsen, N. A., Weihe, S., Garcia, R. S., Siegel, H., Hagdrup, C., Skøtt, M. R., Jensen, A.-M. S., Frische, J. B., Wethelund, K., Christiansen, S. H., Aagaard, S. R., Højlund, S., Westergaard, B., Christiansen, A., Michagin, G., ... Brøchner, A. C. (2025). Invasive mechanical ventilation strategies, adjuvants treatments and adverse events among ICU patients with COVID-19 in Denmark. Acta Anaesthesiologica Scandinavica, 69(2), Article e14571. https://doi.org/10.1111/aas.14571

@article{63769a59f2f74aae860d63c127c2bc02,

title = "Invasive mechanical ventilation strategies, adjuvants treatments and adverse events among ICU patients with COVID-19 in Denmark",

abstract = "AIM: To describe the use of invasive mechanical ventilation core strategies, adjuvant treatments and the occurrence of barotrauma and prolonged ventilation in ICU patients with COVID-19 in Denmark, retrospectively.METHODS: All ICUs admitting COVID-19 patients in Denmark from 10 March 2020 to 2 April 2021 were invited to participate. All patients with COVID-19 who received invasive mechanical ventilation were included and data was retrospectively collected from electronic patient records.RESULTS: A total of 774 patients were invasively ventilated during the first two waves and included; 70\% were males and the median age was 69 years. 340 (51.5\%) of patients never exceeded tidal volumes of 8 mL/kg. For all patients, tidal volumes under 8 mL/kg were applied in 77.6\% (IQR 54.5\%-96.2\%) of the time on ventilator in the ICU; plateau pressure was below 30 cm H2O in 125 (80.6\%) patients; prone positioning was used in 44.7\% of patients. In ICU, 169 of 774 (21.8\%) patients experienced barotrauma and 220 (28.4\%) prolonged ventilation. At 90 days, 306 (39.5\%) had died.CONCLUSIONS: Lung protective ventilation and prone positioning were used in many of the Danish ICU patients with COVID-19, but barotrauma, prolonged ventilation and death occurred frequently.",

keywords = "Humans, COVID-19/therapy, Male, Denmark/epidemiology, Female, Respiration, Artificial, Aged, Retrospective Studies, Middle Aged, Intensive Care Units, Barotrauma/etiology, Tidal Volume, Prone Position, Aged, 80 and over, Critical Care/methods, Core strategies, Covid-19, Adverse events, Mechanical ventilation, Barotrauma",

author = "Nielsen, \{Martine S\} and Ulrich Halekoh and Anders Perner and Trine Haberlandt and Larsen, \{Nikolai Arnold-\} and Sarah Weihe and Garcia, \{Ricardo S\} and Hanna Siegel and Christian Hagdrup and Sk{\o}tt, \{Mads R\} and Jensen, \{Anne-Mette S\} and Frische, \{Jonathan B\} and Kasper Wethelund and Christiansen, \{S{\o}ren H\} and Aagaard, \{S{\o}ren R\} and Sofie H{\o}jlund and Bo Westergaard and Aage Christiansen and George Michagin and Worm, \{Marie S\} and Svendsen, \{Ann-Kristine M\} and \{la Cour\}, \{Kirstine N\} and Jonassen, \{Trine B\} and Jensen, \{Jens U\} and S{\o}rensen, \{Kasper M\} and Nicolai Haase and Rasmussen, \{Bodil S\} and Br{\o}chner, \{Anne C\}",

note = "{\textcopyright} 2025 Acta Anaesthesiologica Scandinavica Foundation.",

year = "2025",

month = feb,

doi = "10.1111/aas.14571",

language = "English",

volume = "69",

journal = "Acta Anaesthesiologica Scandinavica",

issn = "0001-5172",

publisher = "Blackwell Munksgaard",

number = "2",

}

Nielsen, MS, Halekoh, U, Perner, A, Haberlandt, T, Larsen, NA, Weihe, S, Garcia, RS, Siegel, H, Hagdrup, C, Skøtt, MR, Jensen, A-MS, Frische, JB, Wethelund, K, Christiansen, SH, Aagaard, SR, Højlund, S, Westergaard, B, Christiansen, A, Michagin, G, Worm, MS, Svendsen, A-KM, la Cour, KN, Jonassen, TB, Jensen, JU, Sørensen, KM, Haase, N, Rasmussen, BS & Brøchner, AC 2025, 'Invasive mechanical ventilation strategies, adjuvants treatments and adverse events among ICU patients with COVID-19 in Denmark', Acta Anaesthesiologica Scandinavica, vol. 69, no. 2, e14571. https://doi.org/10.1111/aas.14571

TY - JOUR

T1 - Invasive mechanical ventilation strategies, adjuvants treatments and adverse events among ICU patients with COVID-19 in Denmark

AU - Nielsen, Martine S

AU - Halekoh, Ulrich

AU - Perner, Anders

AU - Haberlandt, Trine

AU - Larsen, Nikolai Arnold-

AU - Weihe, Sarah

AU - Garcia, Ricardo S

AU - Siegel, Hanna

AU - Hagdrup, Christian

AU - Skøtt, Mads R

AU - Jensen, Anne-Mette S

AU - Frische, Jonathan B

AU - Wethelund, Kasper

AU - Christiansen, Søren H

AU - Aagaard, Søren R

AU - Højlund, Sofie

AU - Westergaard, Bo

AU - Christiansen, Aage

AU - Michagin, George

AU - Worm, Marie S

AU - Svendsen, Ann-Kristine M

AU - la Cour, Kirstine N

AU - Jonassen, Trine B

AU - Jensen, Jens U

AU - Sørensen, Kasper M

AU - Haase, Nicolai

AU - Rasmussen, Bodil S

AU - Brøchner, Anne C

PY - 2025/2

Y1 - 2025/2

N2 - AIM: To describe the use of invasive mechanical ventilation core strategies, adjuvant treatments and the occurrence of barotrauma and prolonged ventilation in ICU patients with COVID-19 in Denmark, retrospectively.METHODS: All ICUs admitting COVID-19 patients in Denmark from 10 March 2020 to 2 April 2021 were invited to participate. All patients with COVID-19 who received invasive mechanical ventilation were included and data was retrospectively collected from electronic patient records.RESULTS: A total of 774 patients were invasively ventilated during the first two waves and included; 70% were males and the median age was 69 years. 340 (51.5%) of patients never exceeded tidal volumes of 8 mL/kg. For all patients, tidal volumes under 8 mL/kg were applied in 77.6% (IQR 54.5%-96.2%) of the time on ventilator in the ICU; plateau pressure was below 30 cm H2O in 125 (80.6%) patients; prone positioning was used in 44.7% of patients. In ICU, 169 of 774 (21.8%) patients experienced barotrauma and 220 (28.4%) prolonged ventilation. At 90 days, 306 (39.5%) had died.CONCLUSIONS: Lung protective ventilation and prone positioning were used in many of the Danish ICU patients with COVID-19, but barotrauma, prolonged ventilation and death occurred frequently.

AB - AIM: To describe the use of invasive mechanical ventilation core strategies, adjuvant treatments and the occurrence of barotrauma and prolonged ventilation in ICU patients with COVID-19 in Denmark, retrospectively.METHODS: All ICUs admitting COVID-19 patients in Denmark from 10 March 2020 to 2 April 2021 were invited to participate. All patients with COVID-19 who received invasive mechanical ventilation were included and data was retrospectively collected from electronic patient records.RESULTS: A total of 774 patients were invasively ventilated during the first two waves and included; 70% were males and the median age was 69 years. 340 (51.5%) of patients never exceeded tidal volumes of 8 mL/kg. For all patients, tidal volumes under 8 mL/kg were applied in 77.6% (IQR 54.5%-96.2%) of the time on ventilator in the ICU; plateau pressure was below 30 cm H2O in 125 (80.6%) patients; prone positioning was used in 44.7% of patients. In ICU, 169 of 774 (21.8%) patients experienced barotrauma and 220 (28.4%) prolonged ventilation. At 90 days, 306 (39.5%) had died.CONCLUSIONS: Lung protective ventilation and prone positioning were used in many of the Danish ICU patients with COVID-19, but barotrauma, prolonged ventilation and death occurred frequently.

KW - Humans

KW - COVID-19/therapy

KW - Male

KW - Denmark/epidemiology

KW - Female

KW - Respiration, Artificial

KW - Aged

KW - Retrospective Studies

KW - Middle Aged

KW - Intensive Care Units

KW - Barotrauma/etiology

KW - Tidal Volume

KW - Prone Position

KW - Aged, 80 and over

KW - Critical Care/methods

KW - Core strategies

KW - Covid-19

KW - Adverse events

KW - Mechanical ventilation

KW - Barotrauma

U2 - 10.1111/aas.14571

DO - 10.1111/aas.14571

M3 - Article

C2 - 39749940

SN - 0001-5172

VL - 69

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

IS - 2

M1 - e14571

ER -

Invasive mechanical ventilation strategies, adjuvants treatments and adverse events among ICU patients with COVID-19 in Denmark

Abstract

Keywords

Access to Document

Fingerprint

Cite this