Outcomes of an intermediate respiratory care unit in the COVID-19 pandemic

Autor: Mercedes Garcia-Salmones Martin, María Sánchez-Carpintero Abad, Andrea León, Javier Carrillo Hernandez-Rubio, Guillermo Doblare Higuera, Leticia Garcia Rodriguez, Carmen Garcia Torrejon, Angel Rodriguez, Alejandro Mayor Cacho
Rok vydání: 2020
Předmět:
Male
Viral Diseases
Critical Care and Emergency Medicine
Pulmonology
medicine.medical_treatment
medicine.disease_cause
Medical Conditions
Medicine and Health Sciences
Intubation
Prospective Studies
Respiratory Care Units
Multidisciplinary
Respiratory distress
Pharmaceutics
Middle Aged
Hospitals
Survival Rate
Intensive Care Units
Treatment Outcome
Infectious Diseases
Anesthesia
Medicine
Female
medicine.symptom
Respiratory Insufficiency
Nasal cannula
Research Article
Death Rates
Science
Surgical and Invasive Medical Procedures
Tachypnea
Respiratory Disorders
Population Metrics
Respiratory Failure
Drug Therapy
Intubation
Intratracheal
medicine
Humans
Pandemics
Survival rate
Aged
Proportional Hazards Models
Mechanical ventilation
Population Biology
SARS-CoV-2
business.industry
COVID-19
Biology and Life Sciences
Covid 19
Pneumonia
Health Care
Logistic Models
Respiratory failure
Spain
Health Care Facilities
Respiratory Infections
business
Zdroj: PLoS ONE, Vol 15, Iss 12, p e0243968 (2020)
PLoS ONE
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0243968
Popis: Background 15% of COVID-19 patients develop severe pneumonia. Non-invasive mechanical ventilation and high-flow nasal cannula can reduce the rate of endotracheal intubation in adult respiratory distress syndrome, although failure rate is high. Objective To describe the rate of endotracheal intubation, the effectiveness of treatment, complications and mortality in patients with severe respiratory failure due to COVID-19. Methods Prospective cohort study in a first-level hospital in Madrid. Patients with a positive polymerase chain reaction for SARS-CoV-2 and admitted to the Intermediate Respiratory Care Unit with tachypnea, use of accessory musculature or SpO2 O2> 0.5 were included. Intubation rate, medical complications, and 28-day mortality were recorded. Statistical analysis through association studies, logistic and Cox regression models and survival analysis was performed. Results Seventy patients were included. 37.1% required endotracheal intubation, 58.6% suffered medical complications and 24.3% died. Prone positioning was independently associated with lower need for endotracheal intubation (OR 0.05; 95% CI 0.005 to 0.54, p = 0.001). The adjusted HR for death at 28 days in the group of patients requiring endotracheal intubation was 5.4 (95% CI 1.51 to 19.5; p = 0.009). Conclusions The rate of endotracheal intubation in patients with severe respiratory failure from COVID-19 was 37.1%. Complications and mortality were lower in patients in whom endotracheal intubation could be avoided. Prone positioning could reduce the need for endotracheal intubation.
Databáze: OpenAIRE
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