Rationale: Treatment with non-invasive ventilation (NIV) in COVID-19 is frequent. Shortage of Intensive care unit (ICU) beds led clinicians to deliver NIV also outside intensive care units (ICUs). Data about the use of NIV in COVID-19 is limited. Objective: 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 COVID-19 patients, treated with NIV outside the ICU from thirty-one hospitals in Lombardy, Italy. Results: We collected data on demographic, clinical characteristics, ventilatory management and patients' outcome. Of 8753 COVID-19 patients present in the hospitals on the study day, 909 (10%) were receiving NIV outside the ICU. 778/909 (85%) patients were treated with Continuous Positive Airway Pressure (CPAP), delivered by helmet in 617 (68%). NIV failed in 300 patients (37.6%), while 498 (62.4%) were discharged alive without intubation. Overall mortality was 25%. NIV failure occurred in 152/284 (53%) patients with a PaO2/FiO2 ratio < 150 mmHg. Higher C-reactive protein, lower PaO2/FiO2, and platelet counts were independently associated with increased risk of NIV failure. Conclusions: The use of NIV outside the ICUs, in COVID-19 was common, with a predominant use of helmet CPAP, with a rate of success greater than 60% and close to 75% in full treatment patients. C-reactive protein, PaO2/FiO2, platelet counts were independently associated with increased risk of NIV failure. Clinical trial registered with ClinicalTrials.gov (NCT04382235).
Bellani, G., Grasselli, G., Cecconi, M., Antolini, L., Borelli, M., De Giacomi, F., et al. (2021). Noninvasive Ventilatory Support of COVID-19 Patients Outside the Intensive Care Units (WARd-COVID). ANNALS OF THE AMERICAN THORACIC SOCIETY.
|Citazione:||Bellani, G., Grasselli, G., Cecconi, M., Antolini, L., Borelli, M., De Giacomi, F., et al. (2021). Noninvasive Ventilatory Support of COVID-19 Patients Outside the Intensive Care Units (WARd-COVID). ANNALS OF THE AMERICAN THORACIC SOCIETY.|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||No|
|Titolo:||Noninvasive Ventilatory Support of COVID-19 Patients Outside the Intensive Care Units (WARd-COVID)|
|Autori:||Bellani, G; Grasselli, G; Cecconi, M; Antolini, L; Borelli, M; De Giacomi, F; Bosio, G; Latronico, N; Filippini, M; Gemma, M; Giannotti, C; Antonini, B; Petrucci, N; Zerbi, S; Maniglia, P; Castelli, G; Marino, G; Subert, M; Citerio, G; Radrizzani, D; Mediani, T; Lorini, F; Russo, F; Faletti, A; Beindorf, A; Covello, R; Greco, S; Bizzarri, M; Ristagno, G; Mojoli, F; Pradella, A; Severgnini, P; Da Macallè, M; Albertin, A; Ranieri, V; Rezoagli, E; Vitale, G; Magliocca, A; Cappelleri, G; Docci, M; Aliberti, S; Serra, F; Rossi, E; Valsecchi, M; Pesenti, A; Foti, G|
|Data di pubblicazione:||2021|
|Rivista:||ANNALS OF THE AMERICAN THORACIC SOCIETY|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1513/AnnalsATS.202008-1080OC|
|Appare nelle tipologie:||01 - Articolo su rivista|