Background: To evaluate the association between ventilator type and hospital mortality in patients with acute respiratory distress syndrome (ARDS) related to COVID-19 (SARS-CoV2 infection) during the first wave of the disease in France.
Methods: We retrospectively included consecutive adults admitted to the intensive care unit (ICU) of a university-affiliated tertiary hospital for ARDS related to proven COVID-19, between March and May 2020. All patients were intubated. We compared two patient groups defined by whether an ICU ventilator or a less sophisticated ventilator such as a transport ventilator was used. Kaplan-Meier survival curves were plotted. Cox multivariate regression was performed to identify associations between patient characteristics and hospital mortality.
Results: We included 82 patients (61 [74.4%] men) with a median age of 64 years [55–74], of whom 23 (28.1%) died before hospital discharge. By multivariate analysis, factors associated with in-hospital mortality were older age (HR, 1.06/year; 95%CI, 1.00–1.11; P=0.05) and diabetes mellitus (HR, 3.32; 95%CI, 1.13–9.76; P=0.03) but not ventilator type. Using non-ICU ventilator was associated neither with a longer duration of invasive mechanical ventilation (20 [12-36] vs. 25 [15-31] days; P=0.87) nor with a longer ICU stay (24 [14-40] vs. 27 [15-37] days; P=0.64).
Conclusions: In patients with ARDS due to COVID-19, the use of non-ICU ventilators, such as transport ventilators, was not associated with worse outcomes. Although prospective data are needed to confirm our findings, this study suggests that transport ventilators may be valuable during COVID-19 surges that overwhelm ICU resources.