1. Single-Breath Counting Test Predicts Non-Invasive Respiratory Support Requirements in Patients with COVID-19 Pneumonia
- Author
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Yaroslava Longhitano, Christian Zanza, Tatsiana Romenskaya, Angela Saviano, Tonia Persiano, Mirco Leo, Andrea Piccioni, Marta Betti, Antonio Maconi, Ivano Pindinello, Riccardo Boverio, Jordi Rello, Francesco Franceschi, Fabrizio Racca, Institut Català de la Salut, [Longhitano Y] Department of Anesthesiology and Intensive Care, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. Foundation of 'Ospedale Alba-Bra Onlus', Verduno, Italy. Department of Emergency Medicine, Anesthesia and Critical Care Medicine, Michele and Pietro Ferrero Hospital, Verduno, Italy. [Zanza C] Department of Anesthesiology and Intensive Care, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. Foundation of 'Ospedale Alba-Bra Onlus', Verduno, Italy. Department of Emergency Medicine, Anesthesia and Critical Care Medicine, Michele and Pietro Ferrero Hospital, Verduno, Italy. Department of Emergency Medicine, Polyclinic Agostino Gemelli University Hospital, Rome, Italy. [Romenskaya T, Leo M] Department of Anesthesiology and Intensive Care, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. [Saviano A] Department of Emergency Medicine, Polyclinic Agostino Gemelli University Hospital, Rome, Italy. [Persiano T] Department of Medicine and Emergency Medicine, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. [Rello J] Grup de Recerca Clínica/Innovació en la Pneumònia i Sèpsia (CRIPS), Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Clinical Research in the ICU, CHU Nimes, Universite de Nimes-Montpellier, Montpellier, France, and Vall d'Hebron Barcelona Hospital Campus
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continuous positive airway pressure (CPAP) ,high-flow nasal cannula ,enfermedades respiratorias::enfermedades pulmonares::neumonía [ENFERMEDADES] ,Pneumònia - Tractament ,COVID-19 ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,pneumonia ,single breath count ,General Medicine ,Article ,Continuous positive airway pressure (CPAP) ,COVID‐19 ,High‐flow nasal cannula ,Pneumonia ,Single breath count ,Respiratory Tract Diseases::Lung Diseases::Pneumonia [DISEASES] ,Therapeutics::Respiratory Therapy::Oxygen Inhalation Therapy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores] ,terapéutica::terapia respiratoria::tratamiento por inhalación de oxígeno [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,Medicine ,Oxigenoteràpia ,COVID-19 (Malaltia) - Complicacions ,Other subheadings::Other subheadings::/complications [Other subheadings] - Abstract
COVID-19; High-flow nasal cannula; Pneumonia COVID-19; Cánula nasal de alto flujo; Neumonía COVID-19; Cànula nasal d'alt flux; Pneumònia The use of non-invasive respiratory strategies (NIRS) is crucial to improve oxygenation in COVID-19 patients with hypoxemia refractory to conventional oxygen therapy. However, the absence of respiratory symptoms may delay the start of NIRS. The aim of this study was to determine whether a simple bedside test such as single-breath counting test (SBCT) can predict the need for NIRS in the 24 h following the access to Emergency Department (ED). We performed a prospective observational study on 120 patients with COVID-19 pneumonia. ROC curves were used to analyze factors which might predict NIRS requirement. We found that 36% of patients had normal respiratory rate and did not experience dyspnea at rest. 65% of study population required NIRS in the 24 h following the access to ED. NIRS-requiring group presented lower PaO2/FiO2 (235.09 vs. 299.02), SpO2/FiO2 ratio (357.83 vs. 431.07), PaCO2 (35.12 vs. 40.08), and SBCT (24.46 vs. 30.36) and showed higher incidence of dyspnea at rest (57.7% vs. 28.6%). Furthermore, SBCT predicted NIRS requirement even in the subgroup of patients without respiratory symptoms (AUC = 0.882, cut-off = 30). SBCT might be a valuable tool for bedside assessment of respiratory function in patients with COVID-19 pneumonia and might be considered as an early clinical sign of impending respiratory deterioration.
- Published
- 2022