| Title: |
Non‑invasive oxygenation support in acutely hypoxemic COVID‑19 patients admitted to the ICU: a multicenter observational retrospective study |
| Authors: |
Wendel Garcia, Pedro David; Mas Serra, Arantxa; González‑Isern, Cristina; Ferrer Roca, Ricard; Máñez, Rafael; Masclans, Joan R.; Garro, Pau |
| Contributors: |
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; Hospital General de Granollers |
| Source: |
Scientia |
| Publisher Information: |
BMC |
| Publication Year: |
2022 |
| Subject Terms: |
Síndrome del destret respiratori de l'adult; COVID-19 (Malaltia); Unitats de cures intensives; DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections::Severe Acute Respiratory Syndrome; HEALTH SURVEILLANCE::Health Surveillance of Health Services::Health Facilities::Hospitals::Hospital Units::Intensive Care Units; DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections; ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus::síndrome respiratorio agudo grave; ATENCIÓN DE SALUD::instalaciones; servicios y personal de asistencia sanitaria::centros sanitarios::unidades hospitalarias::unidades de cuidados intensivos; ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus |
| Description: |
Acute hypoxemic respiratory failure; COVID-19; Intensive care ; Insuficiència respiratòria hipoxèmica aguda; COVID19; Medicina intensiva ; Insuficiencia respiratoria hipoxémica aguda; COVID-19; Medicina intensiva ; 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 < 0.001. Compared to oxygen masks, high-flow oxygen therapy by nasal cannula was associated with lower ICU mortality (hazard ratio 0.75 [95% CI 0.58-0.98), and the hazard ratio for ICU mortality was 1.21 [95% CI 0.80-1.83] for non-invasive mechanical ventilation. 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. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Critical Care;26(1); https://doi.org/10.1186/s13054-022-03905-5; http://hdl.handle.net/11351/7368 |
| DOI: |
10.1186/s13054-022-03905-5 |
| Availability: |
http://hdl.handle.net/11351/7368; https://doi.org/10.1186/s13054-022-03905-5 |
| Rights: |
Attribution 4.0 International ; http://creativecommons.org/licenses/by/4.0/ ; info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.A81C1238 |
| Database: |
BASE |