• BergRonan M GRMGDepartment of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, D, Andreas Ronit, Nicolai Haase, MøllerMorten HylanderMHDepartment of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Klaus T Kristiansen, Trine Jonassen, Christian Wamberg, Anne Sofie Andreasen, Thomas Mohr, Morten H Bestle, Vibeke L Jørgensen, Niels R Hammer, Anja U Mitchell, Margit Smitt, Anders Møller Greve, Martin Erik Nyeland, Britt Wang Jensen, Anne Helms Andreasen, Janne Petersen, Espen Jimenez Solem, Matilde Winther-Jensen, and Ronni R Plovsing.
• Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
• Acta Anaesthesiol Scand. 2023 Jul 1; 67 (6): 779787779-787.

ObjectiveTo identify PaCO2 trajectories and assess their associations with mortality in critically ill patients with coronavirus disease 2019 (COVID-19) during the first and second waves of the pandemic in Denmark.DesignA population-based cohort study with retrospective data collection.PatientsAll COVID-19 patients were treated in eight intensive care units (ICUs) in the Capital Region of Copenhagen, Denmark, between March 1, 2020 and March 31, 2021.MeasurementsData from the electronic health records were extracted, and latent class analyses were computed based on up to the first 3 weeks of mechanical ventilation to depict trajectories of PaCO2 levels. Multivariable Cox regression analyses were used to calculate adjusted hazard ratios (aHRs) for Simplified Acute Physiology Score 3, sex and age with 95% confidence intervals (CIs) for death according to PaCO2 trajectories.Main ResultsIn latent class trajectory models, including 25,318 PaCO2 measurements from 244 patients, three PaCO2 latent class trajectories were identified: a low isocapnic (Class I; n = 130), a high isocapnic (Class II; n = 80), as well as a progressively hypercapnic (Class III; n = 34) trajectory. Mortality was higher in Class II [aHR: 2.16 {1.26-3.68}] and Class III [aHR: 2.97 {1.63-5.40}]) compared to Class I (reference).ConclusionLatent class analysis of arterial blood gases in mechanically ventilated COVID-19 patients identified distinct PaCO2 trajectories, which were independently associated with mortality.© 2023 Acta Anaesthesiologica Scandinavica Foundation.

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