Effect of the Early Combination of Continuous Positive Airway Pressure and High-Flow Nasal Cannula on Mortality and Intubation Rates in Patients With COVID-19 and Acute Respiratory Distress Syndrome. The DUOCOVID Study.
| Autor: | Teran-Tinedo JR; Intermediate Respiratory Care Unit, Isabel Zendal Emergency Hospital, Madrid, Spain; Pneumology Department, National Hospital for Paraplegics, Toledo, Spain; Complutense University of Madrid, Spain., Gonzalez-Rubio J; Department of Medical Sciences, Faculty of Medicine of Albacete, University of Castilla-La Mancha, Albacete, Spain; Centre for Biomedical Research (CRIB), University of Castilla-La Mancha, Albacete, Spain. Electronic address: Jesus.Gonzalez@uclm.es., Najera A; Department of Medical Sciences, Faculty of Medicine of Albacete, University of Castilla-La Mancha, Albacete, Spain; Centre for Biomedical Research (CRIB), University of Castilla-La Mancha, Albacete, Spain. Electronic address: Alberto.Najera@uclm.es., Lorente-Gonzalez M; Intermediate Respiratory Care Unit, Isabel Zendal Emergency Hospital, Madrid, Spain; Pneumology Department, Infanta Leonor University Hospital, Madrid, Spain., Cano-Sanz E; Intermediate Respiratory Care Unit, Isabel Zendal Emergency Hospital, Madrid, Spain; Emergency Department, Fundación Alcorcon University Hospital, Madrid, Spain., De La Calle-Gil I; Intermediate Respiratory Care Unit, Isabel Zendal Emergency Hospital, Madrid, Spain; Anesthesia Department, Octubre University Hospital, Madrid, Spain., Ortega-Fraile MÁ; Intermediate Respiratory Care Unit, Isabel Zendal Emergency Hospital, Madrid, Spain; Emergency Department, Fundación Alcorcon University Hospital, Madrid, Spain., Carballo-López D; Intermediate Respiratory Care Unit, Isabel Zendal Emergency Hospital, Madrid, Spain; Anesthesia Department, Puerta de Hierro University Hospital, Madrid, Spain., Hernández-Nuñez J; Intermediate Respiratory Care Unit, Isabel Zendal Emergency Hospital, Madrid, Spain; Pneumology Department, San Carlos University Hospital, Madrid, Spain., Churruca-Arróspide M; Intermediate Respiratory Care Unit, Isabel Zendal Emergency Hospital, Madrid, Spain; Pneumology Department, San Carlos University Hospital, Madrid, Spain., Zevallos-Villegas A; Intermediate Respiratory Care Unit, Isabel Zendal Emergency Hospital, Madrid, Spain; Pneumology Department, San Carlos University Hospital, Madrid, Spain., López-Padilla D; Complutense University of Madrid, Spain; Pneumology Department, Gregorio Marañon University Hospital, Madrid, Spain., Puente-Maestú L; Complutense University of Madrid, Spain; Pneumology Department, Gregorio Marañon University Hospital, Madrid, Spain., Navarro-Lopez JD; Centre for Biomedical Research (CRIB), University of Castilla-La Mancha, Albacete, Spain; Department of Medical Sciences, Faculty of Medicine of Ciudad Real, University of Castilla-La Mancha, Ciudad Real, Spain. Electronic address: Juan.Navarro@uclm.es., Jimenez-Diaz L; Centre for Biomedical Research (CRIB), University of Castilla-La Mancha, Albacete, Spain; Department of Medical Sciences, Faculty of Medicine of Ciudad Real, University of Castilla-La Mancha, Ciudad Real, Spain. Electronic address: Lydia.Jimenez@uclm.es., Landete P; Intermediate Respiratory Care Unit, Isabel Zendal Emergency Hospital, Madrid, Spain; Department of Pneumology, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; Pneumology department. Hospital Universitario La Princesa, Madrid, Spain. Electronic address: pedro.landete@salud.madrid.org. |
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| Jazyk: | English; Spanish; Castilian |
| Zdroj: | Archivos de bronconeumologia [Arch Bronconeumol] 2023 May; Vol. 59 (5), pp. 288-294. Date of Electronic Publication: 2023 Feb 02. |
| DOI: | 10.1016/j.arbres.2023.01.009 |
| Abstrakt: | Introduction: Non invasive respiratory support (NIRS) is useful for treating acute respiratory distress syndrome (ARDS) secondary to COVID-19, mainly in mild-moderate stages. Although continuous positive airway pressure (CPAP) seems superior to other NIRS, prolonged periods of use and poor adaptation may contribute to its failure. The combination of CPAP sessions and high-flow nasal cannula (HFNC) breaks could improve comfort and keep respiratory mechanics stable without reducing the benefits of positive airway pressure (PAP). Our study aimed to determine if HFNC+CPAP initiates early lower mortality and endotracheal intubation (ETI) rates. Methods: Subjects were admitted to the intermediate respiratory care unit (IRCU) of a COVID-19 monographic hospital between January and September 2021. They were divided according to Early HFNC+CPAP (first 24h, EHC group) and Delayed HFNC+CPAP (after 24h, DHC group). Laboratory data, NIRS parameters, and the ETI and 30-day mortality rates were collected. A multivariate analysis was performed to identify the risk factors associated with these variables. Results: The median age of the 760 included patients was 57 (IQR 47-66), who were mostly male (66.1%). The median Charlson Comorbidity Index was 2 (IQR 1-3) and 46.8% were obese. The median PaO Conclusions: Particularly in the first 24h after IRCU admission, the HFNC+CPAP combination was associated with a reduction in the 30-day mortality and ETI rates in patients with ARDS secondary to COVID-19. (Copyright © 2023. Published by Elsevier España, S.L.U.) |
| Databáze: | MEDLINE |
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