Effectiveness and safety of noninvasive positive pressure ventilation in the treatment of COVID-19-associated acute hypoxemic respiratory failure: a single center, non-ICU setting experience.
Aged
Aged, 80 and over
COVID-19
/ complications
Chi-Square Distribution
Female
Humans
Infection Control
/ instrumentation
Male
Middle Aged
Multivariate Analysis
Noninvasive Ventilation
/ methods
Organ Dysfunction Scores
Positive-Pressure Respiration
/ methods
Respiratory Insufficiency
/ etiology
Respiratory Mechanics
/ drug effects
Retrospective Studies
Aerosol-generating procedures
COVID-19
Health personnel
Noninvasive ventilation
Personal protective equipment
Respiratory distress syndrome
adult
Journal
Internal and emergency medicine
ISSN: 1970-9366
Titre abrégé: Intern Emerg Med
Pays: Italy
ID NLM: 101263418
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
01
09
2020
accepted:
31
10
2020
pubmed:
23
11
2020
medline:
10
8
2021
entrez:
22
11
2020
Statut:
ppublish
Résumé
The role of noninvasive positive pressure ventilation (NIPPV) in COVID-19 patients with acute hypoxemic respiratory failure (AHRF) is uncertain, as no direct evidence exists to support NIPPV use in such patients. We retrospectively assessed the effectiveness and safety of NIPPV in a cohort of COVID-19 patients consecutively admitted to the COVID-19 general wards of a medium-size Italian hospital, from March 6 to May 7, 2020. Healthcare workers (HCWs) caring for COVID-19 patients were monitored, undergoing nasopharyngeal swab for SARS-CoV-2 in case of onset of COVID-19 symptoms, and periodic SARS-CoV-2 screening serology. Overall, 50 patients (mean age 74.6 years) received NIPPV, of which 22 (44%) were successfully weaned, avoiding endotracheal intubation (ETI) and AHRF-related death. Due to limited life expectancy, 25 (50%) of 50 NIPPV-treated patients received a "do not intubate" (DNI) order. Among these, only 6 (24%) were weaned from NIPPV. Of the remaining 25 NIPPV-treated patients without treatment limitations, 16 (64%) were successfully weaned, 9 (36%) underwent delayed ETI and, of these, 3 (33.3%) died. NIPPV success was predicted by the use of corticosteroids (OR 15.4, CI 1.79-132.57, p 0.013) and the increase in the PaO
Identifiants
pubmed: 33222116
doi: 10.1007/s11739-020-02562-2
pii: 10.1007/s11739-020-02562-2
pmc: PMC7680552
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1183-1190Informations de copyright
© 2020. Società Italiana di Medicina Interna (SIMI).
Références
JAMA. 2020 Apr 7;323(13):1239-1242
pubmed: 32091533
JAMA. 2020 Apr 28;323(16):1574-1581
pubmed: 32250385
Respiration. 2020;99(6):521-542
pubmed: 32564028
Clin Infect Dis. 2020 Jul 27;:
pubmed: 32716496
JAMA. 2016 Jun 14;315(22):2435-41
pubmed: 27179847
Crit Care. 2020 Jun 4;24(1):285
pubmed: 32498689
Crit Care Med. 2016 Jan;44(1):120-9
pubmed: 26474112
Chest. 2004 Sep;126(3):845-50
pubmed: 15364765
Am J Respir Crit Care Med. 2017 Jan 1;195(1):67-77
pubmed: 27753501
Crit Care. 2017 Sep 12;21(1):240
pubmed: 28899408
Chest. 2015 May;147(5):1336-1343
pubmed: 25392954
Lancet Respir Med. 2020 May;8(5):475-481
pubmed: 32105632
Influenza Other Respir Viruses. 2019 Jul;13(4):382-390
pubmed: 30884185
J Clin Med. 2020 Apr 22;9(4):
pubmed: 32331217
JAMA. 2020 Mar 17;323(11):1061-1069
pubmed: 32031570
Intensive Crit Care Nurs. 2020 Jun;58:102859
pubmed: 32249028
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Lancet Respir Med. 2020 Aug;8(8):816-821
pubmed: 32645311
Pulmonology. 2020 Jul - Aug;26(4):186-191
pubmed: 32386886
JAMA. 2020 Jul 7;324(1):57-67
pubmed: 32496521
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Lancet. 2020 Jun 6;395(10239):1763-1770
pubmed: 32442528
Crit Care Med. 2020 Jun;48(6):e440-e469
pubmed: 32224769
N Engl J Med. 2015 Jun 4;372(23):2185-96
pubmed: 25981908
PLoS One. 2012;7(4):e35797
pubmed: 22563403
Eur Respir J. 2017 Aug 31;50(2):
pubmed: 28860265
Am J Respir Crit Care Med. 2004 Jun 1;169(11):1198-202
pubmed: 14990393