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10.1007/s11739-020-02562-2

http://scihub22266oqcxt.onion/10.1007/s11739-020-02562-2
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33222116!7680552!33222116
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suck abstract from ncbi


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pmid33222116      Intern+Emerg+Med 2021 ; 16 (5): 1183-1190
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  • 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 #MMPMID33222116
  • Faraone A; Beltrame C; Crociani A; Carrai P; Lovicu E; Filetti S; Sbaragli S; Alessi C; Cameron Smith M; Angotti C; Fortini A
  • Intern Emerg Med 2021[Aug]; 16 (5): 1183-1190 PMID33222116show ga
  • 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(2)/FiO(2) ratio measured 24-48 h after NIPPV initiation (OR 1.02, CI 1-1.03, p 0.015), while it was inversely correlated with the presence of a DNI order (OR 0.03, CI 0.001-0.57, p 0.020). During the study period, 2 of 124 (1.6%) HCWs caring for COVID-19 patients were diagnosed with SARS-CoV-2 infection. Apart from patients with limited life expectancy, NIPPV was effective in a substantially high percentage of patients with COVID-19-associated AHRF. The risk of SARS-CoV-2 infection among HCWs was low.
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |COVID-19/*complications/therapy[MESH]
  • |Chi-Square Distribution[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Infection Control/instrumentation/methods/statistics & numerical data[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Multivariate Analysis[MESH]
  • |Noninvasive Ventilation/methods/*standards/statistics & numerical data[MESH]
  • |Organ Dysfunction Scores[MESH]
  • |Positive-Pressure Respiration/methods/*standards/statistics & numerical data[MESH]
  • |Respiratory Insufficiency/*etiology/therapy[MESH]
  • |Respiratory Mechanics/drug effects/physiology[MESH]


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