Projects

PRoVENT–COVID provides detailed insights into various aspects of ventilatory support and outcomes in a large set of hospitals in the Netherlands in the first 3 month of the national outbreak.

PRoVENT–COVID is registered at clinicaltrials.gov, NCT04346342, and the protocol is prepublished in Annals of Translational Medicine 2020; 8:1251.

We undertook this analysis of PRoVENT–COVID to describe ventilation management, epidemiological characteristics and outcomes in invasively ventilated COVID–19 patients in the Netherlands, and analyzed ventilation practice over the first 4 days of ventilation, to determine the use of ventilatory interventions that potentially affect outcome.

The findings are reported in the LANCET Respiratory Medicine 2021; 9:139.

This analysis was performed in response to a Letter to the Editor, asking for more data regarding minute ventilation and PaCO₂.

For a deeper insight, we calculated median and mean tidal volume, respiratory rate, and minute volume calculated for each time point per patient over the first 4 days of ventilation.

The findings are reported in the response letter, in the LANCET Respiratory Medicine 2021; 9:e23.

We undertook two literature searches in PubMed to identify observational studies reporting on ventilation management––one in patients with ARDS related to COVID–19, and one in patients with ARDS from another origin.

In patients with ARDS related to COVID–19, ventilation management seems to be quite similar to that in patients with ARDS from another origin.

The report is published in Expert Review of Respiratory Medicine 2021; 15:1013.

In this analysis we investigated the effect of a high PEEP versus a low PEEP strategy on clinically relevant outcomes, including duration of ventilation, distant organ failures, and mortality.

Patients were categorized into 2 groups: patients in whom PEEP titration followed the high PEEP/FiO2 ARDS network table versus patients in whom PEEP tritration followed the low PEEP/FiO2 ARDS network table. The analysis suggest harm from high PEEP.

The findings are reported in the European Journal of Anaesthesiology 2021; 38:1274.

We undertook this analysis of PRoVENT–COVID to describe the use of low tidal volume ventilation and association with outcomes in invasively ventilated COVID–19 patients in the Netherlands.

The report has been submitted for publication.

This analysis investigates the outcomes of patients that survived ICU. The statistical analysis plan is finalized and the analysis has started.

The statistical analysis plan is finalized and the analysis has started.

In PRoVENT–COVID, we noticed remarkable differences in PaCO₂ in the first days of invasive ventilation. This analysis was prefromed to determine the exact incidence of dyscapnia, its relation to metabolic derangements, and association with outcome in COVID–19 patients.

The findings are reported in J Crit Care 2022; 69:154022.

Indirect indices for measuring impaired ventilation, such as the estimated dead space fraction and the ventilatory ratio, have been shown to be independently associated with an increased risk of mortality.

This analysis compared various methods for dead space estimation and the ventilatory ratio in COVID–19 patients and determined their independent capacities for predicting death.

The findings are reported in Critical Care 2021; 25:171.

In this analysis we compared the Mechanical Power of Ventilation during INTELLiVENT–ASV versus with conventional ventilation, in a cross–over comparison in patients that received ventilation with both modes of ventilation.

Compared to conventional ventilation, INTELLiVENT–ASV delivered ventilation with a lower ΔP and less Mechanical Power. These findings favor the use of INTELLiVENT–ASV in COVID–19 ARDS patients.

The findings are reported in Journal of Clinical Medicine 2021; 10:5409

In this analysis we wish to determine the prevalence and outcomes associated with hypoxemia and hyperoxemia. We categorize patients based on the presence of hyperoxemia (PaO₂ > 100 mmHg), hypoxemia (PaO₂ < 60 mmHg) and excessive oxygen use (FiO2 ≥ 0.60 during hyperoxemia).

The findings are reported in Pulmonology 2022; in press.

In this analysis we wished to determine the frequency and patterns of use of prone positioning in patients enrolled into PRoVENT–COVID. In addition, this analysis determined the association between critical aspects of prone positioning and outcome.

The findings are reported in Journal of Clinical Medicine 2021; 10:4783

In this analysis we wish to determine the frequency of early spontaenous breathing and the association with outcome.

The statistical analysis plan is under construction.

In this analysis we determined the frequency and patterns of use of (early and late) tracheostomy in patients enrolled into PRoVENT–COVID. In addition, this analysis determined the association between use and timing of tracheostomy and outcome.

The findings are reported in Pulmonology 2021; 28:18.

This analysis focussed on associations of ΔP and Mechanical Power with outcome in patients enrolled in PRoVENT–COVID.

The findings are reported in Critical Care 2021; 25:283.

In this analysis we determine whether care, specifically ventilator management, in females differed from that in males in PRoVENT–COVID.

The findings are reported in Frontiers in Medicine 2022; in press.

Using granular data from PRoVENT–COVID we studied the existence of clinical subphenotypes in critically ill patients with COVID–19.

Subphenotypes were studied cross–sectionally at admission and longitudinally using time–dependent analysis with 8–hourly data from the first 96 hours of invasive ventilation.

The findings are reported in the LANCET Respiratory Medicine 2021; 9:1377.

This analysis was performed to describe practice of ventilation and mortality rates in invasively ventilated normal-weight (18.5 ≤ BMI ≤ 24.9 kg/m²), overweight (25.0 ≤ BMI ≤ 29.9 kg/m²), and obese (BMI > 30 kg/m²) COVID–19 ARDS patients.

The findings are reported in the Journal of Clinical Medicine 2021; 10:1176.

This analyis is performed to describe fluid management in invasively ventilated COVID–19 ARDS patients and factors associated with a higher positive cumulative fluid balance. In addition, the association of cumulative fluid balance with outcomes in these patients will be studied.

The report has been accepted for publication and will soon be available.

This analysis was performed to describe practice of ventilation and mortality rates in 4 age catergories of invasively ventilated COVID–19 ARDS patients.

The report has been published in Aging 2022; 14: 1087.

The results of this analysis indicate that there is a risk of 'mis–classification' of ARDS patients and this would have a significant effect on the outcome and conclusions from the trial regarding success or not of a given intervention.

The findings are reported in Journal of Critical Care 2021; 65;237.

This analysis focussed on associations of time–varying ΔP and Mechanical Power with outcome in patients enrolled in PRoVENT–COVID.

The findings are reported in Frontiers in Medicine 2021; 8:725265.