During the first wave of the Coronavirus-19 (COVID-19) pandemic, due to an overflow of patients in the ICU, continuous positive airway pressure (CPAP) was used as a last resort to mechanical ventilation. The purpose of this study is to evaluate prognostic factors in COVID-19 severe respiratory failure patients treated with helmet CPAP. We reviewed the medical records of COVID-19 respiratory failure patients treated with H-CPAP at the Emergency Department from February 23rd to March 14th, 2020. A total of 202 (40%) patients admitted for respiratory failure due to COVID-19 pneumonia were considered. 129 (64%) patients received H-CPAP, while 73 (36%) required endotracheal intubation and invasive mechanical ventilation despite initial H-CPAP. 99 patients (49%) died. The mortality rate in the IMV group was 37%, compared to 56% in the group that received only H-CPAP (p=0.004). The age and comorbidities of patients in the two groups differed significantly (p<0.001). Age and PaO2/FiO2 were identified as the only independent risk factors for death. Identifying these independent predictors of mortality in patients with acute respiratory insufficiency may help clinicians optimize treatment escalation.
Giannone, A., Piazza, I., Preti, C., Pisano, E., Ghirardi, A., Benetti, A., et al. (2024). Outcomes of bailout use of continuous positive airway pressure in patients with severe COVID-19 respiratory failure. EMERGENCY CARE JOURNAL, 20(2) [10.4081/ecj.2024.12225].
Outcomes of bailout use of continuous positive airway pressure in patients with severe COVID-19 respiratory failure
Fagiuoli S.;Lorini F. L.;
2024
Abstract
During the first wave of the Coronavirus-19 (COVID-19) pandemic, due to an overflow of patients in the ICU, continuous positive airway pressure (CPAP) was used as a last resort to mechanical ventilation. The purpose of this study is to evaluate prognostic factors in COVID-19 severe respiratory failure patients treated with helmet CPAP. We reviewed the medical records of COVID-19 respiratory failure patients treated with H-CPAP at the Emergency Department from February 23rd to March 14th, 2020. A total of 202 (40%) patients admitted for respiratory failure due to COVID-19 pneumonia were considered. 129 (64%) patients received H-CPAP, while 73 (36%) required endotracheal intubation and invasive mechanical ventilation despite initial H-CPAP. 99 patients (49%) died. The mortality rate in the IMV group was 37%, compared to 56% in the group that received only H-CPAP (p=0.004). The age and comorbidities of patients in the two groups differed significantly (p<0.001). Age and PaO2/FiO2 were identified as the only independent risk factors for death. Identifying these independent predictors of mortality in patients with acute respiratory insufficiency may help clinicians optimize treatment escalation.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.