Noninvasive ventilatory support of patients with covid-19 outside the intensive care units (ward-covid)
| Autor: | Emanuela Rossi, Ferdinando Luca Lorini, Nicola Petrucci, Giovanni Marino, Danilo Radrizzani, Marta M. Bizzarri, Angela Faletti, Giuseppe Citerio, Emanuele Rezoagli, Gianluca Cappelleri, Andrea Beindorf, Maria Grazia Valsecchi, Matteo Subert, Giacomo Grasselli, Andrea Pradella, Gian Paolo Castelli, Giuseppe Ristagno, Paolo Severgnini, Simone Maria Zerbi, Giancarlo Bosio, Maurizio Cecconi, Antonio Pesenti, Marco Gemma, Giacomo Bellani, Federica De Giacomi, Nicola Latronico, B. Antonini, Massimo Borelli, Filippo Serra, Marta Da Macallè, Francesco Mojoli, Stefano Aliberti, Matteo Filippini, Giuseppe Foti, Laura Antolini, Remo Daniel Covello, Andrea Albertin, V. Marco Ranieri, Stefano Greco, Claudia Giannotti, Giovanni Vitale, Teresa S. Mediani, Aurora Magliocca, Paolo Maniglia, Filippo Russo, Mattia Docci |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Critical Care medicine.medical_treatment law.invention 03 medical and health sciences 0302 clinical medicine law Fraction of inspired oxygen Intensive care Oxygen therapy Patients' Rooms medicine Intubation Intratracheal Intubation Cannula Humans 030212 general & internal medicine Continuous positive airway pressure Letters Prospective Studies Treatment Failure Hospital Mortality Prospective cohort study Hypoxia Original Research Aged Noninvasive Ventilation Continuous Positive Airway Pressure business.industry SARS-CoV-2 Oxygen Inhalation Therapy COVID-19 Middle Aged Intensive care unit Coronavirus Intensive Care Units Intratracheal 030228 respiratory system Respiratory failure Italy Emergency medicine Noninvasive ventilatory support Female Respiratory Insufficiency business |
| Zdroj: | Annals of the American Thoracic Society |
| Popis: | Rationale: Treatment with noninvasive ventilation (NIV) in coronavirus disease (COVID-19) is frequent. Shortage of intensive care unit (ICU) beds led clinicians to deliver NIV also outside ICUs. Data about the use of NIV in COVID-19 is limited. Objectives: To describe the prevalence and clinical characteristics of patients with COVID-19 treated with NIV outside the ICUs. To investigate the factors associated with NIV failure (need for intubation or death). Methods: In this prospective, single-day observational study, we enrolled adult patients with COVID-19 who were treated with NIV outside the ICU from 31 hospitals in Lombardy, Italy. Results: We collected data on demographic and clinical characteristics, ventilatory management, and patient outcomes. Of 8,753 patients with COVID-19 present in the hospitals on the study day, 909 (10%) were receiving NIV outside the ICU. A majority of patients (778/909; 85%) patients were treated with continuous positive airway pressure (CPAP), which was delivered by helmet in 617 (68%) patients. NIV failed in 300 patients (37.6%), whereas 498 (62.4%) patients were discharged alive without intubation. Overall mortality was 25%. NIV failure occurred in 152/284 (53%) patients with an arterial oxygen pressure (PaO2)/fraction of inspired oxygen (Fi O2) ratio 60% and close to 75% in full-treatment patients. C-reactive protein, PaO2/Fi O2, and platelet counts were independently associated with increased risk of NIV failure. Clinical trial registered with ClinicalTrials.gov (NCT04382235). |
| Databáze: | OpenAIRE |
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