1. Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective study
- Author
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Pedro David Wendel-Garcia, Arantxa Mas, Cristina González-Isern, Ricard Ferrer, Rafael Máñez, Joan-Ramon Masclans, Elena Sandoval, Paula Vera, Josep Trenado, Rafael Fernández, Josep-Maria Sirvent, Melcior Martínez, Mercedes Ibarz, Pau Garro, José Luis Lopera, María Bodí, Joan Carles Yébenes-Reyes, Carles Triginer, Imma Vallverdú, Anna Baró, Fernanda Bodí, Paula Saludes, Mauricio Valencia, Ferran Roche-Campo, Arturo Huerta, Francisco José Cambra, Carme Barberà, Jorge Echevarria, Óscar Peñuelas, Jordi Mancebo, for the UCIsCAT study group, [Wendel Garcia PD] Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland. [Mas A] Servei de Cures Intensives, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Spain. [González-Isern C] Departament de Tecnologia Mèdica, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain. [Ferrer R] Servei de Cures Intensives, Grup de Recerca SODIR, Hospital Universitari General de La Vall d'Hebron, Barcelona, Spain [Máñez R] Servei de Cures Intensives, L'Hospitalet de Llobregat, Barcelona, Spain. [Masclans JR] Servei de Cures Intensives, Hospital del Mar, Grup de Recerca GREPAC-IMIM, Departament Ciències, Experimentals I de la Salut (DCEXS) UPF, Barcelona, Spain. [Baró A] Hospital de Santa Caterina, Institut d’Assistència Sanitària(IAS), Salt, Spain, Institut d'Assistència Sanitària, [Wendel-Garcia PD] Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland. [Mas A] Intensive Care Department, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Spain. [González-Isern C] Medical Technology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain. [Ferrer R] Intensive Care Department/SODIR Research Group, Hospital Universitari General de La Vall d’Hebron, Barcelona, Spain. [Máñez R] Intensive Care Department, L’Hospitalet de Llobregat, Barcelona, Spain. [Masclans JR] Intensive Care Department, Hospital del Mar, GREPAC Research Group ‑ IMIM, Department Ciències, Experimentals I de La Salut (DCEXS) UPF, Barcelona, Spain. [Garro P] Intensive Care Department, Hospital General de Granollers, Granollers, Spain, and Hospital General de Granollers
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enfermedades respiratorias::trastornos respiratorios::insuficiencia respiratoria [ENFERMEDADES] ,Nose ,Critical Care and Intensive Care Medicine ,Other subheadings::/therapy [Other subheadings] ,COVID-19 (Malaltia) ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections::Severe Acute Respiratory Syndrome [DISEASES] ,Non-invasive oxygenation ,Medicina intensiva ,Intensive care ,Adult respiratory distress syndrome ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,Intubation, Intratracheal ,Cannula ,Humans ,Acute hypoxemic respiratory failure ,Síndrome del destret respiratori de l'adult ,Unitats de cures intensives ,Retrospective Studies ,vigilancia sanitaria de los servicios de salud::centros sanitarios::hospitales::unidades hospitalarias::unidades de cuidados intensivos [VIGILANCIA SANITARIA] ,Síndrome del destret respiratori de l'adult - Tractament ,Noninvasive Ventilation ,Intensive care units ,Otros calificadores::/terapia [Otros calificadores] ,SARS-CoV-2 ,Teràpia respiratòria ,RC86-88.9 ,Oxygen Inhalation Therapy ,COVID-19 ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,Medical emergencies. Critical care. Intensive care. First aid ,Oxygen therapy ,Respiratory Tract Diseases::Respiration Disorders::Respiratory Insufficiency [DISEASES] ,Intensive Care Units ,instalaciones, servicios y personal de asistencia sanitaria::centros sanitarios::unidades hospitalarias::unidades de cuidados intensivos [ATENCIÓN DE SALUD] ,Nas ,Spain ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus::síndrome respiratorio agudo grave [ENFERMEDADES] ,Respiratory therapy ,Respiratory Insufficiency ,Health Surveillance of Health Services::Health Facilities::Hospitals::Hospital Units::Intensive Care Units [HEALTH SURVEILLANCE] ,Oxigenoteràpia - Abstract
Background Non-invasive oxygenation strategies have a prominent role in the treatment of acute hypoxemic respiratory failure during the coronavirus disease 2019 (COVID-19). While the efficacy of these therapies has been studied in hospitalized patients with COVID-19, the clinical outcomes associated with oxygen masks, high-flow oxygen therapy by nasal cannula and non-invasive mechanical ventilation in critically ill intensive care unit (ICU) patients remain unclear. Methods In this retrospective study, we used the best of nine covariate balancing algorithms on all baseline covariates in critically ill COVID-19 patients supported with > 10 L of supplemental oxygen at one of the 26 participating ICUs in Catalonia, Spain, between March 14 and April 15, 2020. Results Of the 1093 non-invasively oxygenated patients at ICU admission treated with one of the three stand-alone non-invasive oxygenation strategies, 897 (82%) required endotracheal intubation and 310 (28%) died during the ICU stay. High-flow oxygen therapy by nasal cannula (n = 439) and non-invasive mechanical ventilation (n = 101) were associated with a lower rate of endotracheal intubation (70% and 88%, respectively) than oxygen masks (n = 553 and 91% intubated), p Conclusion In critically ill COVID-19 ICU patients and, in the absence of conclusive data, high-flow oxygen therapy by nasal cannula may be the approach of choice as the primary non-invasive oxygenation support strategy.
- Published
- 2022