IRIS PubliCatt

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society.

Tài, P., Leo, H., Giacomo, B., Fabiana, M., Irene, A., Gaëtan, B., Ewan C, G., Giacomo, G., Jon Henrik, L., Jordi, M., Oscar, P., Lise, P., Antonio, P., Hannah, W., Frank, V. H., Laurent, B., John G, L., Abrough, F., P Acharya, S., Amin, P., Arabi, Y., Aragao, I., Bauer, P., Beduneau, G., Beitler, J., Berkius, J., Bugedo, G., Camporota, L., Cerny, V., Cho, Y., Clarkson, K., Estenssoro, E., Goligher, E., Grasselli, G., Gritsan, A., Mohammadreza Hashemian, S., Hermans, G., M Heunks, L., Jovanovic, B., Kurahashi, K., Henrik Laake, J., Matamis, D., Moerer, O., Molnar, Z., Ozyilmaz, E., Panka, B., Papali, A., Peñuelas, Ó., Perbet, S., Piquilloud, L., Qiu, H., Abdel Razek, A., Rittayamai, N., Roldan, R., Serpa Neto, A., Szuldrzynski, K., Talmor, D., Tomescu, D., Van Haren, F., Villagomez, A., Ali Zeggwagh, A., Abe, T., Aboshady, A., Acampo-De Jong, M., Acharya, S., Adderley, J., Adiguzel, N., Kumar Agrawal, V., Aguilar, G., Aguirre, G., Aguirre-Bermeo, H., Ahlström, B., Akbas, T., Akker, M., Al Sadeh, G., Alamri, S., Algaba, A., Ali, M., Aliberti, A., Manuel Allegue, J., Alvarez, D., Amador, J., H Andersen, F., Ansari, S., Apichatbutr, Y., Apostolopoulou, O., Arabi, Y., Arellano, D., Arica, M., Arikan, H., Arinaga, K., Arnal, J., Asano, K., Asín-Corrochano, M., Milagrito Avalos Cabrera, J., Avila Fuentes, S., Aydemir, S., Aygencel, G., Azevedo, L., Bacakoglu, F., Badie, J., Baedorf Kassis, E., Bai, G., Balaraj, G., Ballico, B., Banner-Goodspeed, V., Banwarie, P., Barbieri, R., Baronia, A., Barrett, J., Barrot, L., Emilio Barrueco-Francioni, J., Barry, J., Bauer, P., Bawangade, H., Beavis, S., Beck, E., Beehre, N., Belenguer Muncharaz, A., Bellani, G., Belliato, M., Bellissima, A., Beltramelli, R., Ben Souissi, A., Benitez-Cano, A., Benlamin, M., Benslama, A., Bento, L., Benvenuti, D., Berkius, J., Bernabe, L., Bersten, A., Berta, G., Bertini, P., Bertram-Ralph, E., Besbes, M., Roberto Bettini, L., Beuret, P., Bewley, J., Bezzi, M., Bhakhtiani, L., Bhandary, R., Bhowmick, K., Bihari, S., Bissett, B., Blythe, D., Bocher, S., Boedjawan, N., M Bojanowski, C., Boni, E., Boraso, S., Borelli, M., Borello, S., Borislavova, M., J Bosma, K., Bottiroli, M., Boyd, O., Bozbay, S., Briva, A., Brochard, L., Bruel, C., Bruni, A., Buehner, U., Bugedo, G., Bulpa, P., Burt, K., Buscot, M., Buttera, S., Cabrera, J., Caccese, R., Caironi, P., Canchos Gutierrez, I., Canedo, N., Cani, A., Cappellini, I., Carazo, J., Pablo Cardonnet, L., Carpio, D., Carriedo, D., Carrillo, R., Carvalho, J., Caser, E., Castelli, A., Castillo Quintero, M., Castro, H., Catorze, N., Cengiz, M., Cereijo, E., Ceunen, H., Chaintoutis, C., Chang, Y., Chaparro, G., Chapman, C., Chau, S., Eugenia Chavez, C., Chelazzi, C., Chelly, J., Chemouni, F., Chen, K., Chena, A., Chiarandini, P., Chilton, P., Chiumello, D., Cho, Y., Chou-Lie, Y., Chudeau, N., Cinel, I., Cinnella, G., Clark, M., Clark, T., Clarkson, K., Clementi, S., Coaguila, L., Jaspe Codecido, A., Collins, A., Colombo, R., Conde, J., Consales, G., Cook, T., Coppadoro, A., Cornejo, R., Cortegiani, A., Coxo, C., Neville Cracchiolo, A., Crespo Ramirez, M., Crova, P., Cruz, J., Cubattoli, L., Çukurova, Z., Curto, F., Czempik, P., D'Andrea, R., Da Silva Ramos, F., Dangers, L., Danguy Des Déserts, M., Danin, P., Dantas, F., Daubin, C., Dawei, W., De Haro, C., De Jesus Montelongo, F., De Mendoza, D., De Pablo, R., De Pascale, G., De Rosa, S., Decavèle, M., Declercq, P., Deicas, A., Del Carmen Campos Moreno, M., Dellamonica, J., Delmas, B., Demirkiran, O., Demirkiran, H., Dendane, T., Di Mussi, R., Diakaki, C., Diaz, A., Diaz, W., Dikmen, Y., Dimoula, A., Doble, P., Doha, N., Domingos, G., Dres, M., Dries, D., Duggal, A., Duke, G., Dunts, P., Dybwik, K., Dykyy, M., Eckert, P., Efe, S., Elatrous, S., Elay, G., S Elmaryul, A., Elsaadany, M., Elsayed, H., Elsayed, S., Emery, M., Ena, S., Eng, K., A Englert, J., Erdogan, E., Ergin Ozcan, P., Eroglu, E., Escobar, M., Esen, F., Esen Tekeli, A., Esquivel, A., Esquivel Gallegos, H., Ezzouine, H., Facchini, A., Faheem, M., Fanelli, V., Fernanda Farina, M., Fartoukh, M., Fehrle, L., Feng, F., Feng, Y., Fernandez, I., Fernandez, B., Lorena Fernandez-Rodriguez, M., Ferrando, C., João Ferreira Da Silva, M., Ferreruela, M., Ferrier, J., Jesús Flamm Zamorano, M., Flood, L., Floris, L., Fluckiger, M., Forteza, C., Fortunato, A., Frans, E., Frattari, A., Fredes, S., Frenzel, T., Fumagalli, R., Andres Furche, M., Fusari, M., Fysh, E., Luis Galeas-Lopez, J., Galerneau, L., Garcia, A., Fernanda Garcia, M., Garcia, E., Garcia Olivares, P., Garlicki, J., Garnero, A., Garofalo, E., Gautam, P., Gazenkampf, A., Gelinotte, S., Gelormini, D., Ghrenassia, E., Giacomucci, A., Giannoni, R., Gigante, A., Glober, N., Gnesin, P., Gollo, Y., Gomaa, D., Gomero Paredes, R., Gomes, R., Alejandro Gomez, R., Gomez, O., Gomez, A., Gondim, L., Gonzalez, M., Gonzalez, I., Gonzalez-Castro, A., Gordillo Romero, O., Gordo, F., Gouin, P., Graf Santos, J., Grainne, R., Grando, M., Granov Grabovica, S., Grasselli, G., Grasso, S., Grasso, R., Grimmer, L., Grissom, C., Gritsan, A., Gu, Q., Guan, X., Guarracino, F., Guasch, N., Guatteri, L., Gueret, R., Guérin, C., Guerot, E., Guitard, P., Gül, F., Gumus, A., Gurjar, M., Gutierrez, P., Hachimi, A., Hadzibegovic, A., Hagan, S., Hammel, C., Han Song, J., Hanlon, G., Mohammadreza Hashemian, S., Heines, S., Henriksson, J., Herbrecht, J., Omar Heredia Orbegoso, G., Hermans, G., Hermon, A., Hernandez, R., Hernandez, C., Herrera, L., Herrera-Gutierrez, M., Heunks, L., Hidalgo, J., Hill, D., Holmquist, D., Homez, M., Hongtao, X., Hormis, A., Horner, D., Carmen Hornos, M., Hou, M., House, S., Housni, B., Hugill, K., Humphreys, S., Humbert, L., Hunter, S., Hwa Young, L., Iezzi, N., Ilutovich, S., Inal, V., Innes, R., Ioannides, P., Antonio Iotti, G., Ippolito, M., Irie, H., Iriyama, H., Itagaki, T., Izura, J., Izza, S., Jabeen, R., Jamaati, H., Jamadarkhana, S., Jamoussi, A., Jankowski, M., Alberto Jaramillo, L., Jeon, K., Jeong Lee, S., Jeswani, D., Jha, S., Jiang, L., Jing, C., Jochmans, S., Anders Johnstad, B., Jongmin, L., Joret, A., Jovanovic, B., Junhasavasdikul, D., Teresa Jurado, M., Kam, E., Kamohara, H., Kane, C., Kara, I., Karakurt, S., Karnjanarachata, C., Kataoka, J., Katayama, S., Kaushik, S., Kelebek Girgin, N., Kerr, K., Kerslake, I., Khairnar, P., Khalid, A., Khan, A., K Khanna, A., Khorasanee, R., Kienhorst, D., Kirakli, C., Knafelj, R., Kol Kol, M., Kongpolprom, N., Kopitko, C., Korkmaz Ekren, P., Kubisz-Pudelko, A., Kulcsar, Z., Kumasawa, J., Kurahashi, K., Kuriyama, A., Kutchak, F., Henrik Laake, J., Labarca, E., Labat, F., Laborda, C., Alberto Laca Barrera, M., Lagache, L., Landaverde Lopez, A., Lanspa, M., Lascari, V., Le Meur, M., Hwan Lee, S., Ju Lee, Y., Lee, J., Lee, W., Lee, J., Legernaes, T., Leiner, T., Lemiale, V., Leonor, T., M Lepper, P., Li, D., Li, H., Li, O., Raquel Lima, A., Lind, D., Litton, E., Liu, N., Liu, L., Liu, J., Llitjos, J., Llorente, B., Lopez, R., Elizabeth Lopez, C., Lopez Nava, C., Lovazzano, P., Lu, M., Lucchese, F., Lugano, M., Lugo Goytia, G., Luo, H., Lynch, C., Macheda, S., Hugo Madrigal Robles, V., Maurizio Maggiore, S., Magret Iglesias, M., Malaga, P., Mallapura Maheswarappa, H., Malpartida, G., Malyarchikov, A., Mansson, H., Manzano, A., Marey, I., Marin, N., Del Carmen Marin, M., Markman, E., Martin, F., Martin, A., Martin Dal Gesso, C., Martinez, F., Martínez-Fidalgo, C., Martin-Loeches, I., Mas, A., Masaaki, S., Maseda, E., Massa, E., Mattsson, A., Maugeri, J., Mccredie, V., Mccullough, J., Mcguinness, S., Mckown, A., Medve, L., Mei, C., Mellado Artigas, R., Mendes, V., Khalaf Ebraheim Mervat, M., Michaux, I., Mikhaeil, M., Milagros, O., Milet, I., Teresa Millan, M., Minwei, Z., Mirabella, L., Mishra, S., Mistraletti, G., Mochizuki, K., Moerer, O., Moghal, A., Mojoli, F., Molin, A., Molnar, Z., Montiel, R., Montini, L., Monza, G., Mora Aznar, M., Morakul, S., Morales, M., Moreno Torres, D., Rolando Morocho Tutillo, D., Motherway, C., Mouhssine, D., Mouloudi, E., Muñoz, T., Munoz De Cabo, C., Mustafa, M., Muthuchellappan, R., Muthukrishnan, M., Muttini, S., Nagata, I., Nahar, D., Nakanishi, M., Nakayama, I., Antonio Namendys-Silva, S., Nanchal, R., Nandakumar, S., Nasi, A., Nasir, K., Navalesi, P., Naz Aslam, T., Nga Phan, T., Nichol, A., Niiyama, S., Nikolakopoulou, S., Nikolic, E., Nitta, K., Noc, M., Nonas, S., Nseir, S., Nur Soyturk, A., Obata, Y., Oeckler, R., Oguchi, M., Ohshimo, S., Oikonomou, M., Ojados, A., Teresa Oliveira, M., Oliveira Filho, W., Oliveri, C., Olmos, A., Omura, K., Cristina Orlandi, M., Orsenigo, F., Ortiz-Ruiz De Gordoa, L., Ota, K., Ovalle Olmos, R., Öveges, N., Oziemski, P., Ozkan Kuscu, O., Özyilmaz, E., Pachas Alvarado, F., Pagella, G., Palaniswamy, V., Luis Palazon Sanchez, E., Palmese, S., Pan, G., Pan, W., Panka, B., Papanikolaou, M., Papavasilopoulou, T., Parekh, A., Parke, R., J Parrilla, F., Parrilla, D., Pasha, T., Pasin, L., Patão, L., Patel, M., Patel, G., Kumar Pati, B., Patil, J., Pattnaik, S., Paul, D., Pavesi, M., Alejandra Pavlotsky, V., Paz, G., Paz, E., Pecci, E., Pellegrini, C., Gabriela Peña Padilla, A., Perchiazzi, G., Pereira, T., Pereira, V., Perez, M., Perez Calvo, C., Perez Cheng, M., Perez Maita, R., Pérez-Araos, R., Perez-Teran, P., Perez-Torres, D., Perkins, G., Persona, P., Petnak, T., Petrova, M., Pham, T., Philippart, F., Picetti, E., Pierucci, E., Piervincenzi, E., Pinciroli, R., Pintado, M., Piquilloud, L., Piraino, T., Piras, S., Piras, C., Pirompanich, P., Pisani, L., Platas, E., Plotnikow, G., Porras, W., Porta, V., Portilla, M., Portugal, J., Povoa, P., Prat, G., Pratto, R., Preda, G., Prieto, I., Prol-Silva, E., Pugh, R., Qi, Y., Qian, C., Qin, T., Qiu, H., Qu, H., Quintana, T., Quispe Sierra, R., Quispe Soto, R., Rabbani, R., Rabee, M., Rabie, A., Augusta Rahe Pereira, M., Rai, A., Raj Ashok, S., Rajab, M., Ramdhani, N., Ramey, E., Ranieri, M., Rathod, D., Ray, B., Mahmud Redwanul Huq, S., Regli, A., Reina, R., Resano Sarmiento, N., Reynaud, F., Rialp, G., Ricart, P., Rice, T., Richardson, A., Rieder, M., Rinket, M., Rios, F., Rios, F., Risso Vazquez, A., Rittayamai, N., Riva, I., Rivette, M., Roca, O., Roche-Campo, F., Rodriguez, C., Rodriguez, G., Rodriguez Gonzalez, D., Yanina Rodriguez Tucto, X., Rogers, A., Elena Romano, M., Rørtveit, L., Rose, A., Roux, D., Rouze, A., Nahuel Rubatto Birri, P., Ruilan, W., Ruiz Robledo, A., Luis Ruiz-Aguilar, A., Sadahiro, T., Saez, I., Sagardia, J., Saha, R., Saha, R., Saiphoklang, N., Saito, S., Salem, M., Sales, G., Salgado, P., Samavedam, S., Sami Mebazaa, M., Samuelsson, L., San Juan Roman, N., Sanchez, P., Sanchez-Ballesteros, J., Sandoval, Y., Sani, E., Santos, M., Santos, C., Sanui, M., Saravanabavan, L., Sari, S., Sarkany, A., Sauneuf, B., Savioli, M., Sazak, H., Scano, R., Schneider, F., Schortgen, F., J Schultz, M., Leonie Schwarz, G., Seçkin Yücesoy, F., Seely, A., Seiler, F., Seker Tekdos, Y., Seok Chan, K., Serano, L., Serednicki, W., Serpa Neto, A., Setten, M., Shah, A., Shah, B., Shang, Y., Shanmugasundaram, P., Shapovalov, K., Shebl, E., Shiga, T., Shime, N., Shin, P., Short, J., Shuhua, C., Siddiqui, S., Ignacio Silesky Jimenez, J., Silva, D., Silva Sales, B., Simons, K., Ågot Sjøbø, B., Slessor, D., Smiechowicz, J., Smischney, N., Smith, P., Smith, T., Smith, M., Snape, S., Snyman, L., Soetens, F., Sook Hong, K., Ángel Sosa Medellin, M., Soto, G., Souloy, X., Sousa, E., Sovatzis, S., Sozutek, D., Spadaro, S., Spagnoli, M., Spångfors, M., Spittle, N., Spivey, M., Stapleton, A., Stefanovic, B., Stephenson, L., Stevenson, E., Strand, K., Teresa Strano, M., Straus, S., Sun, C., Sun, R., Sundaram, V., Sunpark, T., Surlemont, E., Sutherasan, Y., Szabo, Z., Szuldrzynski, K., Tainter, C., Takaba, A., Tallott, M., Tamasato, T., Tang, Z., Tangsujaritvijit, V., Taniguchi, L., Taniguchi, D., Tarantino, F., Teerapuncharoen, K., Temprano, S., Terragni, P., Terzi, N., Thakur, A., Theerawit, P., W Thille, A., Thomas, M., Thungtitigul, P., Thyrault, M., Tilouch, N., Timenetsky, K., Tirapu, J., Todeschini, M., Tomas, R., Tomaszewski, C., Tonetti, T., Tonnelier, A., Trinder, J., 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[doi:10.1016/S2213-2600(22)00449-0] [https://hdl.handle.net/10807/224819]

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

De Pascale, Gennaro;Montini, Luca;
2023

Abstract

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society.
2023
Inglese
THE LANCET RESPIRATORY MEDICINE
Tài, P., Leo, H., Giacomo, B., Fabiana, M., Irene, A., Gaëtan, B., Ewan C, G., Giacomo, G., Jon Henrik, L., Jordi, M., Oscar, P., Lise, P., Antonio, P., Hannah, W., Frank, V. H., Laurent, B., John G, L., Abrough, F., P Acharya, S., Amin, P., Arabi, Y., Aragao, I., Bauer, P., Beduneau, G., Beitler, J., Berkius, J., Bugedo, G., Camporota, L., Cerny, V., Cho, Y., Clarkson, K., Estenssoro, E., Goligher, E., Grasselli, G., Gritsan, A., Mohammadreza Hashemian, S., Hermans, G., M Heunks, L., Jovanovic, B., Kurahashi, K., Henrik Laake, J., Matamis, D., Moerer, O., Molnar, Z., Ozyilmaz, E., Panka, B., Papali, A., Peñuelas, Ó., Perbet, S., Piquilloud, L., Qiu, H., Abdel Razek, A., Rittayamai, N., Roldan, R., Serpa Neto, A., Szuldrzynski, K., Talmor, D., Tomescu, D., Van Haren, F., Villagomez, A., Ali Zeggwagh, A., Abe, T., Aboshady, A., Acampo-De Jong, M., Acharya, S., Adderley, J., Adiguzel, N., Kumar Agrawal, V., Aguilar, G., Aguirre, G., Aguirre-Bermeo, H., Ahlström, B., Akbas, T., Akker, M., Al Sadeh, G., Alamri, S., Algaba, A., Ali, M., Aliberti, A., Manuel Allegue, J., Alvarez, D., Amador, J., H Andersen, F., Ansari, S., Apichatbutr, Y., Apostolopoulou, O., Arabi, Y., Arellano, D., Arica, M., Arikan, H., Arinaga, K., Arnal, J., Asano, K., Asín-Corrochano, M., Milagrito Avalos Cabrera, J., Avila Fuentes, S., Aydemir, S., Aygencel, G., Azevedo, L., Bacakoglu, F., Badie, J., Baedorf Kassis, E., Bai, G., Balaraj, G., Ballico, B., Banner-Goodspeed, V., Banwarie, P., Barbieri, R., Baronia, A., Barrett, J., Barrot, L., Emilio Barrueco-Francioni, J., Barry, J., Bauer, P., Bawangade, H., Beavis, S., Beck, E., Beehre, N., Belenguer Muncharaz, A., Bellani, G., Belliato, M., Bellissima, A., Beltramelli, R., Ben Souissi, A., Benitez-Cano, A., Benlamin, M., Benslama, A., Bento, L., Benvenuti, D., Berkius, J., Bernabe, L., Bersten, A., Berta, G., Bertini, P., Bertram-Ralph, E., Besbes, M., Roberto Bettini, L., Beuret, P., Bewley, J., Bezzi, M., Bhakhtiani, L., Bhandary, R., Bhowmick, K., Bihari, S., Bissett, B., Blythe, D., Bocher, S., Boedjawan, N., M Bojanowski, C., Boni, E., Boraso, S., Borelli, M., Borello, S., Borislavova, M., J Bosma, K., 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[doi:10.1016/S2213-2600(22)00449-0] [https://hdl.handle.net/10807/224819]
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