Emergency air evacuation of patients with acute respiratory failure due to SARS-CoV-2 from Mayotte to Reunion Island.
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
03 Dec 2021
03 Dec 2021
Historique:
received:
26
05
2021
accepted:
03
11
2021
entrez:
20
1
2022
pubmed:
21
1
2022
medline:
1
2
2022
Statut:
ppublish
Résumé
In February 2021, an explosion of cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia overwhelmed the only hospital in Mayotte. To report a case series of patients with acute respiratory failure (ARF) due to SARS-CoV-2 who were evacuated by air from Mayotte to Reunion Island.This retrospective observational study evaluated all consecutive patients with ARF due to SARS-CoV-2 who were evacuated by air from Mayotte Hospital to the intensive care unit (ICU) of Félix Guyon University Hospital in Reunion Island between February 2, and March 5, 2021.A total of 43 patients with SARS-CoV-2 pneumonia were evacuated by air, for a total flight time of 2 hours and a total travel time of 6 hours. Of these, 38 patients (88.4%) with a median age of 55 (46-65) years presented with ARF and were hospitalized in our ICU. Fifteen patients were screened for the SARS-CoV-2 501Y.V2 variant, all of whom tested positive. Thirteen patients (34.2%) developed an episode of severe hypoxemia during air transport, and the median paO2/FiO2 ratio was lower on ICU admission (140 [102-192] mmHg) than on departure (165 [150-200], P = .022). Factors associated with severe hypoxemia during air transport was lack of treatment with curare (P = .012) and lack of invasive mechanical ventilation (P = .003). Nine patients (23.7%) received veno-venous extracorporeal membrane oxygenation support in our ICU. Seven deaths (18.4%) occurred in hospital.Emergency air evacuation of patients with ARF due to SARS-CoV-2 was associated with severe hypoxemia but remained feasible. In cases of ARF due to SARS-CoV-2 requiring emergency air evacuation, sedated patients receiving invasive mechanical ventilation and curare should be prioritized over nonintubated patients. It is noteworthy that patients with SARS-CoV-2 pneumonia related to the 501Y.V2 variant were very severe despite their young age.
Identifiants
pubmed: 35049190
doi: 10.1097/MD.0000000000027881
pii: 00005792-202112030-00026
pmc: PMC9191376
doi:
Substances chimiques
Curare
8063-06-7
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e27881Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Ann Intensive Care. 2020 Mar 30;10(1):37
pubmed: 32232685
BMJ. 2021 Mar 9;372:n579
pubmed: 33687922
Scand J Trauma Resusc Emerg Med. 2020 May 14;28(1):40
pubmed: 32410706
Ann Intensive Care. 2021 Mar 31;11(1):54
pubmed: 33788010
N Engl J Med. 2007 Jan 18;356(3):262-70
pubmed: 17229953
Intensive Care Med. 2002 Aug;28(8):1122-5
pubmed: 12185435
Ann Intensive Care. 2013 Apr 12;3(1):10
pubmed: 23587445
J Cardiothorac Vasc Anesth. 2020 Jun;34(6):1426-1430
pubmed: 32033890
Crit Care. 2012 Oct 03;16(5):R179
pubmed: 23034103
PLoS One. 2012;7(4):e35797
pubmed: 22563403
Intensive Care Med. 2016 May;42(5):949-950
pubmed: 26928040
Eur Heart J Acute Cardiovasc Care. 2018 Jun;7(4):371-378
pubmed: 28664820
Euro Surveill. 2020 Jan;25(3):
pubmed: 31992387
Nature. 2021 Apr;592(7854):438-443
pubmed: 33690265
BMJ. 2007 Oct 20;335(7624):806-8
pubmed: 17947786
Anaesth Crit Care Pain Med. 2021 Feb;40(1):100786
pubmed: 33232835
BMJ Mil Health. 2020 Dec 24;:
pubmed: 33361440
JAMA. 2020 May 12;323(18):1839-1841
pubmed: 32215647
Air Med J. 2021 Jan-Feb;40(1):76-78
pubmed: 33455633
Eur Respir J. 2020 May 14;55(5):
pubmed: 32299867