{
    "abstract": "New treatments and increased experience are changing the management of hospitalized coronavirus disease 2019 patients but the impact on ICU management is unclear.\nTo examine characteristics, ventilatory management, and outcomes of critically ill patients in two distinct waves of the pandemic.\nObservational cohort study in an ICU in a single-center university-affiliated U.K. hospital. Two-hundred ten adults with coronavirus disease 2019 admitted to ICU between March 17, 2020, to May 31, 2020, and September 1, 2020, to December 10, 2020, with hourly data and 100% follow-up to ICU discharge.\nData were extracted from the electronic medical record for patient characteristics and clinical data. Patients were classified into distinct waves of the pandemic and assessed for differences between the two waves.\nThe duration of noninvasive ventilation/nasal high flow increased in wave 2 versus wave 1, both in self-ventilating patients (107 vs 72 hr; \nOur data suggest that management of critically ill coronavirus disease 2019 patients is changing with more survivors avoiding invasive mechanical ventilation. Duration of noninvasive ventilation/nasal high flow use is increasing, which may be associated with worsening outcomes for individuals who require invasive mechanical ventilation. Among invasively ventilated patients, changes in the use of and response to prone positioning and increased length of stay following tracheostomy may imply that the care of these patients is becoming more challenging.",
    "authors": [
        {
            "affiliation": "Adult Critical Care Department, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.\nDepartment of Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.",
            "firstname": "Alexander J",
            "initials": "AJ",
            "lastname": "Parker"
        },
        {
            "affiliation": "Adult Critical Care Department, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.",
            "firstname": "Monalisa",
            "initials": "M",
            "lastname": "Mishra"
        },
        {
            "affiliation": "Adult Critical Care Department, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.",
            "firstname": "Pooja",
            "initials": "P",
            "lastname": "Tiwary"
        },
        {
            "affiliation": "Adult Critical Care Department, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.",
            "firstname": "Mike",
            "initials": "M",
            "lastname": "Sharman"
        },
        {
            "affiliation": "Department of Anaesthesia and Peri-operative Medicine, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.",
            "firstname": "Manu",
            "initials": "M",
            "lastname": "Priya-Sharma"
        },
        {
            "affiliation": "Department of Anaesthesia and Peri-operative Medicine, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.",
            "firstname": "Alastair",
            "initials": "A",
            "lastname": "Duncan"
        },
        {
            "affiliation": "Department of Anaesthesia and Peri-operative Medicine, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.",
            "firstname": "Mohan",
            "initials": "M",
            "lastname": "Shanmugam"
        },
        {
            "affiliation": "Department of Anaesthesia and Peri-operative Medicine, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.",
            "firstname": "Kailash",
            "initials": "K",
            "lastname": "Bhatia"
        },
        {
            "affiliation": "Department of Statistics, Research & Innovation, Manchester University NHS Foundation Trust, Manchester, United Kingdom.\nCentre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.",
            "firstname": "Catherine",
            "initials": "C",
            "lastname": "Fullwood"
        },
        {
            "affiliation": "Adult Critical Care Department, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.",
            "firstname": "Andrew D",
            "initials": "AD",
            "lastname": "Martin"
        },
        {
            "affiliation": "Adult Critical Care Department, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.\nDepartment of Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.",
            "firstname": "Anthony",
            "initials": "A",
            "lastname": "Wilson"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.",
    "doi": "10.1097/CCE.0000000000000587",
    "journal": "Critical care explorations",
    "keywords": [
        "acute respiratory distress syndrome",
        "coronavirus disease 2019",
        "intensive care",
        "outcomes",
        "proning",
        "ventilation"
    ],
    "methods": null,
    "publication_date": "2021-12-10",
    "pubmed_id": "34881367\n32678530\n33631065\n32859674\n33933206\n20843245\n23688302\n33684356\n33397421\n33826927\n33512941\n25691263\n27753501\n33196858\n33428874\n33812669\n31112383\n25981908",
    "results": "The duration of noninvasive ventilation/nasal high flow increased in wave 2 versus wave 1, both in self-ventilating patients (107 vs 72 hr; ",
    "title": "A Tale of Two Waves: Changes in the Use of Noninvasive Ventilation and Prone Positioning in Critical Care Management of Coronavirus Disease 2019.",
    "xml": "<Element 'PubmedArticle' at 0x788506d0a890>"
}