COVID-19 Research Paper Volume 14, Issue 3 pp 1087—1109

The effect of age on ventilation management and clinical outcomes in critically ill COVID–19 patients––insights from the PRoVENT–COVID study

Liselotte Hol1, , Paula Van Oosten2, , Sunny Nijbroek1, , Anissa Tsonas2, , Michela Botta2, , Ary Serpa Neto2,3,4, , Frederique Paulus2,5, , Marcus Schultz2,6,7, , PRoVENT–COVID *, , Collaborative group #, ,

  • 1 Department of Anesthesiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
  • 2 Department of Intensive Care, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
  • 3 Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paolo, Brazil
  • 4 Department of Critical Care Medicine, Austin Hospital and University of Melbourne, Melbourne, Australia
  • 5 Faculty of Health, ACHIEVE, Center of Applied Research, University of Applied Research, Amsterdam, Netherlands
  • 6 Mahidol Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
  • 7 Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
* PRactive of VENTilation in COVID–19 Patients
# PRoVENT–COVID Investigators are presented in the Supplementary Materials section

Received: November 24, 2021       Accepted: January 12, 2022       Published: January 31, 2022
How to Cite

Copyright: © 2022 Hol et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Introduction: We analyzed the association of age with ventilation practice and outcomes in critically ill COVID–19 patients requiring invasive ventilation.

Methods: Posthoc analysis of the PRoVENT–COVID study, an observational study performed in 22 ICUs in the first 3 months of the national outbreak in the Netherlands. The coprimary endpoint was a set of ventilator parameters, including tidal volume normalized for predicted bodyweight, positive end–expiratory pressure, driving pressure, and respiratory system compliance in the first 4 days of invasive ventilation. Secondary endpoints were other ventilation parameters, the use of rescue therapies, pulmonary and extrapulmonary complications in the first 28 days in the ICU, hospital– and ICU stay, and mortality.

Results: 1122 patients were divided into four groups based on age quartiles. No meaningful differences were found in ventilation parameters and in the use of rescue therapies for refractory hypoxemia in the first 4 days of invasive ventilation. Older patients received more often a tracheostomy, developed more frequently acute kidney injury and myocardial infarction, stayed longer in hospital and ICU, and had a higher mortality.

Conclusions: In this cohort of invasively ventilated critically ill COVID–19 patients, age had no effect on ventilator management. Higher age was associated with more complications, longer length of stay in ICU and hospital and a higher mortality.


APACHE: Acute Physiology and Chronic Health Evaluation; ARDS: Acute Respiratory Distress Syndrome; BMI: Body Mass Index; EtCO2: End tidal Carbon dioxide; COPD: Chronic Obstructive Pulmonary Disease; COVID-19: coronavirus disease 2019; Crs: Respiratory system compliance; ECMO: Extracorporeal membrane oxygenation; FiO2: Inspired Oxygen Fraction; PaO2: Partial Pressure of Oxygen; PEEP: Positive End-Expiratory Pressure; PBW: Predicted Body Weight; SAPS: The Simplified Acute Physiology Score; SOFA: Sequential Organ Failure; VT: Tidal Volume; ΔP: Driving Pressure.