Sistema de Salut de Catalunya
[Wendel Garcia PD] Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland. [Mas A] Servei de Cures Intensives, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Spain. [González-Isern C] Departament de Tecnologia Mèdica, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain. [Ferrer R] Servei de Cures Intensives, Grup de Recerca SODIR, Hospital Universitari General de La Vall d'Hebron, Barcelona, Spain [Máñez R] Servei de Cures Intensives, L'Hospitalet de Llobregat, Barcelona, Spain. [Masclans JR] Servei de Cures Intensives, Hospital del Mar, Grup de Recerca GREPAC-IMIM, Departament Ciències, Experimentals I de la Salut (DCEXS) UPF, Barcelona, Spain. [Baró A] Hospital de Santa Caterina, Institut d’Assistència Sanitària(IAS), Salt, Spain
Institut d'Assistència Sanitària
2022-02-15T08:06:52Z
2022-02-15T08:06:52Z
2022-02-08
Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Insuficiència respiratòria hipoxèmica aguda; Medicina intensiva
Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Insuficiencia respiratoria hipoxémica aguda; Cuidados intensivos
Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Acute hypoxemic respiratory failure; Intensive care
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 efcacy of these therapies has been studied in hospitalized patients with COVID-19, the clinical outcomes associated with oxygen masks, high-fow oxy‑gen therapy by nasal cannula and non-invasive mechanical ventilation in critically ill intensive care unit (ICU) patientsremain unclear.Methods: In this retrospective study, we used the best of nine covariate balancing algorithms on all baseline covari‑ates 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-fow 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-fow 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-fow oxygen therapy by nasal cannula may be the approach of choice as the primary non-invasive oxygenation support strategy
Article
Published version
English
Síndrome del destret respiratori de l'adult - Tractament; COVID-19 (Malaltia); Medicina intensiva; 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::Respiratory Tract Diseases::Respiration Disorders::Respiratory Insufficiency; Other subheadings::Other subheadings::/therapy; ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus::síndrome respiratorio agudo grave; VIGILANCIA SANITARIA::vigilancia sanitaria de los servicios de salud::centros sanitarios::hospitales::unidades hospitalarias::unidades de cuidados intensivos; ENFERMEDADES::enfermedades respiratorias::trastornos respiratorios::insuficiencia respiratoria; Otros calificadores::Otros calificadores::/terapia
BMC
Critical Care;26(1)
https://doi.org/10.1186/s13054-022-03905-5
Attribution 4.0 International
https://creativecommons.org/licenses/by/4.0/
