| Title: |
Variability of oxygen requirements in critically ill COVID-19 patients |
| Authors: |
Huth SF; Rothkopf; A Smith L; White N; Bassi GL; Suen JY; Fraser JF; Lorini F |
| Contributors: |
Huth, S; Rothkopf; A Smith, L; White, N; Bassi, G; Suen, J; Fraser, J; Lorini, F |
| Publisher Information: |
GB; The University of Edinburgh * Global Health Society |
| Publication Year: |
2024 |
| Collection: |
Università degli Studi di Milano-Bicocca: BOA (Bicocca Open Archive) |
| Subject Terms: |
adult; aged; article; artificial ventilation; controlled study; coronavirus disease 2019; critically ill patient; female; flow rate; health care facility; high flow nasal cannula therapy; human; intensive care unit; invasive ventilation; major clinical study; male; middle income country; oxygen consumption; oxygen delivery device; oxygen therapy; probability; therapy; treatment duration |
| Description: |
Background The global scarcity of medical oxygen has proven to be catastrophic during the surges in COVID-19 cases over the past two years, with the heaviest burden felt in low- and middle-income countries. Despite its criticality, data and analyses of oxygen consumption, even for typical clinical cases, are missing. Consequently, planning oxygen needs, particularly with variable surges in COVID-19 cases, has presented a substantial challenge to policymakers and hospital decision-makers. Methods We performed a sub-analysis of the COVID-19 Critical Care Consortium database assessing the oxygen consumption requirements of COVID-19 patients admitted to intensive care units between February 2020 and October 2021. We calculated descriptive statistics for oxygen flowrates, stratified by oxygen supplementation method, and developed a multi-state model for estimating the frequency, therapy duration, probability of transition, and number of oxygen therapy modes per patient. Results Overall, 12429 patients from 35 countries received oxygen support on at least one day of their hospitalisation. Of the patients with measurable flow rates, 6142 received invasive mechanical ventilation, 838 received high-flow nasal oxygen, and 257 received both modalities. The median flow rate for mechanical ventilation was 3.2 L per minute (interquartile range (IQR)=2.0–4.9), with a median duration of 12 days (IQR=6–24), while the median flow rate for highflow nasal cannula was 40 L per minute (IQR=15–55), with a median duration of three days (IQR=2–6). Conclusions Oxygen consumption among critical COVID-19 patients varies by mode of delivery (invasive ventilation vs high-flow nasal cannula), across patients, and over treatment duration. Therefore, it is essential that health facilities routinely monitor oxygen utilization to better inform oxygen delivery system design and regular supply planning. Registration ClinicalTrials.gov: CTG2021-01 ACTRN 12620000421932. |
| Document Type: |
article in journal/newspaper |
| File Description: |
STAMPA |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/38390629; info:eu-repo/semantics/altIdentifier/wos/WOS:001170489700001; volume:14; journal:JOURNAL OF GLOBAL HEALTH; https://hdl.handle.net/10281/524333 |
| DOI: |
10.7189/jogh.14.05012 |
| Availability: |
https://hdl.handle.net/10281/524333; https://doi.org/10.7189/jogh.14.05012 |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative Commons ; license uri:http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.5DD77B5B |
| Database: |
BASE |