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10.1183/23120541.00026-2021

http://scihub22266oqcxt.onion/10.1183/23120541.00026-2021
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33738306!7848791!33738306
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suck abstract from ncbi


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pmid33738306      ERJ+Open+Res 2021 ; 7 (1): ä
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  • Conservative management of COVID-19 associated hypoxaemia #MMPMID33738306
  • Voshaar T; Stais P; Kohler D; Dellweg D
  • ERJ Open Res 2021[Jan]; 7 (1): ä PMID33738306show ga
  • BACKGROUND: Invasive mechanical ventilation of hypoxaemic coronavirus disease 2019 (COVID-19) patients is associated with mortality rates of >50%. We evaluated clinical outcome data of two hospitals that agreed on a predefined protocol for restrictive use of invasive ventilation where the decision to intubate was based on the clinical presentation and oxygen content rather than on the degree of hypoxaemia. METHOD: Data analysis was carried out of patients with positive PCR-testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), typical history, and symptoms and pulmonary infiltrates who exhibited oxygen saturation values of <93%. RESULTS: We identified 78 patients who met the inclusion criteria. The oxygen saturation nadir was 84.4+/-6.5% for the whole group. 53 patients (68%) received nasal oxygen (group 1), 17 patients (22%) were treated with nasal high-flow continuous positive airway pressure (CPAP), noninvasive ventilation or a combination thereof (group 2), and eight patients (10%) were intubated (group 3). The Horovitz index was 216+/-8 for group 1, 157+/-13 for group 2 and 106+/-15 for group 3. Oxygen content was 14.5+/-2.5, 13.4+/-1.9 and 11.6+/-2.6 mL O(2).dL(-1) for the three respective groups. Overall mortality was 7.7%; the mortality of intubated patients was 50%. Overall, 93% of patients could be discharged on room air. CONCLUSION: Permissive hypoxaemia where decisions for the level of respiratory therapy were based on the clinical presentation and oxygen content resulted in low intubation rates, low overall mortality and a low number of patients who require oxygen after discharge.
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