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Predictor factors for non-invasive mechanical ventilation failure in severe COVID-19 patients in the intensive care unit: a single-center retrospective study.
Romanelli, Antonio; Toigo, Pietro; Scarpati, Giuliana; Caccavale, Angela; Lauro, Gianluigi; Baldassarre, Daniela; Oliva, Filomena; Lacava, Graziella; Pascale, Gabriele; Piazza, Ornella.
  • Romanelli A; Department of Anaesthesia and Intensive Care, AOU "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy. antonioromanelli86@gmail.com.
  • Toigo P; Department of Anaesthesia and Intensive Care, AOU "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy.
  • Scarpati G; Department of Anaesthesia and Intensive Care, AOU "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy.
  • Caccavale A; Department of Medicine and Surgery, Università Degli Studi di Salerno, Baronissi, Italy.
  • Lauro G; Department of Anaesthesia and Intensive Care, AOU "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy.
  • Baldassarre D; Department of Anaesthesia and Intensive Care, AOU "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy.
  • Oliva F; Department of Anaesthesia and Intensive Care, AOU "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy.
  • Lacava G; Department of Medicine and Surgery, Università Degli Studi di Salerno, Baronissi, Italy.
  • Pascale G; Department of Anaesthesia and Intensive Care, AOU "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy.
  • Piazza O; Department of Medicine and Surgery, Università Degli Studi di Salerno, Baronissi, Italy.
J Anesth Analg Crit Care ; 2(1): 10, 2022 Feb 15.
Article in English | MEDLINE | ID: covidwho-1690848
ABSTRACT

BACKGROUND:

During the COVID-19 pandemia, non-invasive mechanical ventilation (NIV) has been largely applied. Few data are available about predictors of NIV failure in critical COVID-19 patients admitted to ICU. The aim of this study is to analyze clinical and laboratory features able to predict non-invasive ventilation success in avoiding endotracheal intubation.

METHODS:

A retrospective observational study was performed in our COVID-19 ICU during a 6-month period. Demographic, clinical, laboratory, imaging, and outcome data were extracted from electronic and paper medical records and anonymously collected.

RESULTS:

Eighty-two severe COVID-19 patients were supported by NIV at ICU admission. The median PaO2/FiO2 ratio was 125 [98.5-177.7]. NIV failed in 44 cases (53%). Patients who experienced NIV failure had a higher Charlson Comorbidity Index (median value 4) compared to those who were dismissed without endotracheal intubation (median 2, p < 0.0001). At Cox regression analysis, the Charlson Comorbidity Index represented a predictive factor related to NIV failure. PaO2/FiO2, CPK, INR, and AT III at ICU admission showed a significant relationship with the outcome, when single variables were adjusted for the Charlson Comorbidity Index.

CONCLUSION:

The Charlson Comorbidity Index may be helpful to stratify patients' risk of NIV failure in a severe COVID-19 population; even if this study, retrospective design does not allow definitive conclusions.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal: J Anesth Analg Crit Care Year: 2022 Document Type: Article Affiliation country: S44158-022-00038-7

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal: J Anesth Analg Crit Care Year: 2022 Document Type: Article Affiliation country: S44158-022-00038-7