LTACH Mechanical Ventilator Liberation Rate Much Higher for Patients With COVID-19

Patients requiring mechanical ventilation and tracheostomy for COVID-19 in a long-term acute care hospital (LTACH) appear to have better chances of recovery than patients with mechanical ventilation and tracheostomy unrelated to COVID-19, according to findings published in Chest.

“The current focus in COVID-19 response is the acute hospital system,” wrote Tamas Dolinay, MD, PhD, and colleagues from the University of California Los Angeles Department of Medicine and Barlow Respiratory Hospital. “Little is known what happens to those who survived the acute phase of the disease with chronic critical illness. To our knowledge, our study is the first to report outcomes of COVID-19 patients requiring mechanical ventilation beyond acute care hospitalization.”

The study investigated rates of mechanical ventilator liberation and other outcomes for 165 tracheostomized patients with respiratory failure: 37 were admitted for COVID-19 and 128 for non-COVID-19 reasons.

According to the study, adjusted ventilator liberation rates were 91.4% for patients with COVID-19-associated respiratory failure compared with 56.0% with respiratory failure unrelated to COVID-19.

Patients in the COVID-19 group also had better physical recovery and shorter LTACH length of stay, the study found. Specifically, adjusted mean change in the Functional Status Score for the Intensive Care Unit was 9.49 in the COVID-19 group compared with 2.08 in nonCOVID-19 group. Meanwhile, adjusted median LTACH length of stay was 39 days for the COVID-19 group compared with 52 days for the nonCOVID-19 group.

“Patients with COVID-19 associated respiratory failure may benefit from continued ventilator liberation attempts and complex rehabilitation beyond the acute care setting,” researchers advised.

Reference:
Dolinay T, Jun D, Chen L, Gornbein J. Mechanical ventilator liberation of COVID-19 patients in long-term acute care facility. Chest. 2022;S0012-3692(22)00396-8. doi:10.1016/j.chest.2022.02.030