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Non-invasive Oxygen Strategies to Manage Confirmed COVID-19 Patients in Indian Intensive Care Units: A Survey.
- Source :
-
Indian Journal of Critical Care Medicine . Oct2020, Vol. 24 Issue 10, p926-931. 6p. 2 Charts, 2 Graphs. - Publication Year :
- 2020
-
Abstract
- Background: About 5% of hospitalized coronavirus disease 2019 (COVID-19) patients will need intensive care unit (ICU) admission for hypoxemic respiratory failure requiring oxygen support. The choice between early mechanical ventilation and noninvasive oxygen therapies, such as, high- flow nasal oxygen (HFNO) and/or noninvasive positive-pressure ventilation (NPPV) has to balance the contradictory priorities of protecting healthcare workers by minimizing aerosol-generation and optimizing resource management. This survey over two timeframes aimed to explore the controversial issue of location and noninvasive oxygen therapy in non-intubated ICU patients using a clinical vignette. Materials and methods: An online survey was designed, piloted, and distributed electronically to Indian intensivists/anesthetists, from Private Hospitals, Government Hospitals, and Medical College Hospitals (the latter two referred to as first-responder hospitals), who are directly responsible for admitting/managing patients in ICU. Results: Of the 204 responses (125/481 in phase 1 and 79/320 in phase 2), 183 responses were included. Respondents from first-responder hospitals were more willing to manage non-intubated hypoxemic patients in neutral pressure rooms, while respondents from private hospitals preferred negative-pressure rooms (p < 0.001). In both the phases, private hospital doctors were less comfortable to use any form of noninvasive oxygen therapies in neutral-pressure rooms compared to first-responder hospitals (low-flow oxygen therapy: 72 vs 50%, p < 0.01; HFNO: 47 vs 24%, p < 0.01 and NPPV: 38 vs 28%, p = 0.20). Interpretation: Variations existed in practices among first-responder and private intensivists/anesthetists. The resource optimal private hospital intensivists/anesthetists were less comfortable using noninvasive oxygen therapies in managing COVID-19 patients. This may reflect differential resource availability necessitating resolution at national, state, and local levels. [ABSTRACT FROM AUTHOR]
- Subjects :
- *INTENSIVE care units
*VIRAL pneumonia
*COVID-19
*ACADEMIC medical centers
*POSITIVE pressure ventilation
*NASAL cannula
*PHYSICIANS' attitudes
*FISHER exact test
*ARTIFICIAL respiration
*NURSE anesthetists
*OXYGEN therapy
*CRITICAL care medicine
*QUESTIONNAIRES
*CASE studies
*PUBLIC hospitals
*DESCRIPTIVE statistics
*PROPRIETARY hospitals
*DATA analysis software
*HYPOXEMIA
Subjects
Details
- Language :
- English
- ISSN :
- 09725229
- Volume :
- 24
- Issue :
- 10
- Database :
- Academic Search Index
- Journal :
- Indian Journal of Critical Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 161386236