Noninvasive Ventilatory Support of Patients with COVID-19 outside the Intensive Care Units (WARd-COVID)
Rattachement africain : it. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Abstract Rationale Treatment with noninvasive ventilation (NIV) in coronavirus disease (COVID-19) is frequent. Shortage of intensive care unit (ICU) beds led clinicians to deliver NIV also outside ICUs. Data about the use of NIV in COVID-19 is limited. Objectives To describe the prevalence and clinical characteristics of patients with COVID-19 treated with NIV outside the ICUs. To investigate the factors associated with NIV failure (need for intubation or death). Methods In this prospective, single-day observational study, we enrolled adult patients with COVID-19 who were treated with NIV outside the ICU from 31 hospitals in Lombardy, Italy. Results We collected data on demographic and clinical characteristics, ventilatory management, and patient outcomes. Of 8,753 patients with COVID-19 present in the hospitals on the study day, 909 (10%) were receiving NIV outside the ICU. A majority of patients (778/909; 85%) patients were treated with continuous positive airway pressure (CPAP), which was delivered by helmet in 617 (68%) patients. NIV failed in 300 patients (37.6%), whereas 498 (62.4%) patients were discharged alive without intubation. Overall mortality was 25%. NIV failure occurred in 152/284 (53%) patients with an arterial oxygen pressure (PaO2)/fraction of inspired oxygen (Fi O2) ratio <150 mm Hg. Higher C-reactive protein and lower PaO2/Fi O2 and platelet counts were independently associated with increased risk of NIV failure. Conclusions The use of NIV outside the ICUs was common in COVID-19, with a predominant use of helmet CPAP, with a rate of success >60% and close to 75% in full-treatment patients. C-reactive protein, PaO2/Fi O2, and platelet counts were independently associated with increased risk of NIV failure. Clinical trial registered with ClinicalTrials.gov (NCT04382235).
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Noninvasive Ventilatory Support of Patients with COVID-19 outside the Intensive Care Units (WARd-COVID)
- Date Crossref
- 01/06/2021
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Azienda Ospedaliera San Gerardo pays non établi dans la noticeÉtablissement de santé
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University of Milano-Bicocca Department of Medicine and Surgery pays non établi dans la noticeUniversité ou école supérieure
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Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico pays non établi dans la noticeÉtablissement de santé
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Ospedale Maggiore Department of Anesthesia pays non établi dans la noticeÉtablissement de santé
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Humanitas University Department of Biomedical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Istituti di Ricovero e Cura a Carattere Scientifico pays non établi dans la noticeÉtablissement de santé
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Azienda Ospedaliera Treviglio pays non établi dans la noticeÉtablissement de santé
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Istituti Ospitalieri di Cremona pays non établi dans la noticeÉtablissement de santé
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Azienda Socio Sanitaria Territoriale di Cremona pays non établi dans la noticeOrganisme public
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Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia pays non établi dans la noticeÉtablissement de santé
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University of Brescia Department of Surgical Specialties pays non établi dans la noticeUniversité ou école supérieure
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Fatebenefratelli Hospital Department of Anesthesia and Intensive Care Unit pays non établi dans la noticeÉtablissement de santé
Azienda Ospedaliera San Gerardo, Department of Medicine and Surgery — University of Milano-Bicocca et Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.