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Continuous positive airway pressure and pronation outside the Intensive Care Unit in COVID-19 acute respiratory distress syndrome.
Ramirez, Giuseppe A; Bozzolo, Enrica P; Castelli, Elena; Marinosci, Alessandro; Angelillo, Piera; Damanti, Sarah; Scotti, Raffaella; Gobbi, Agnese; Centurioni, Clarissa; DI Scala, Flavia; Morgillo, Anna; Castagna, Antonella; Conte, Caterina; Assanelli, Andrea; DE Cobelli, Francesco; Calcaterra, Barbara; Cabrini, Luca; Carcò, Francesco; Turi, Stefano; Silvani, Paolo; Dagna, Lorenzo; Zangrillo, Alberto; Landoni, Giovanni; Tresoldi, Moreno.
  • Ramirez GA; Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy.
  • Bozzolo EP; Vita-Salute San Raffaele University, Milan, Italy.
  • Castelli E; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Marinosci A; Department of Cardiothoracic, IRCCS San Raffaele Hospital, Milan, Italy.
  • Angelillo P; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Damanti S; Unit of Hematology, IRCCS San Raffaele Hospital, Milan, Italy.
  • Scotti R; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Gobbi A; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Centurioni C; Vita-Salute San Raffaele University, Milan, Italy.
  • DI Scala F; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Morgillo A; Vita-Salute San Raffaele University, Milan, Italy.
  • Castagna A; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Conte C; Vita-Salute San Raffaele University, Milan, Italy.
  • Assanelli A; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • DE Cobelli F; Vita-Salute San Raffaele University, Milan, Italy.
  • Calcaterra B; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Cabrini L; Vita-Salute San Raffaele University, Milan, Italy.
  • Carcò F; Unit of Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy.
  • Turi S; Vita-Salute San Raffaele University, Milan, Italy.
  • Silvani P; Unit of Organ Transplants, IRCCS San Raffaele Hospital, Milan, Italy.
  • Dagna L; Unit of Hematology, IRCCS San Raffaele Hospital, Milan, Italy.
  • Zangrillo A; Vita-Salute San Raffaele University, Milan, Italy.
  • Landoni G; Unit of Radiology, IRCCS San Raffaele Hospital, Milan, Italy.
  • Tresoldi M; Emergency Department, IRCCS San Raffaele Hospital, Milan, Italy.
Minerva Med ; 113(2): 281-290, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1847990
Semantic information from SemMedBD (by NLM)
1. Pronation ASSOCIATED_WITH Respiratory Distress Syndrom
Subject
Pronation
Predicate
ASSOCIATED_WITH
Object
Respiratory Distress Syndrom
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Continuous Positive Airway Pressure ADMINISTERED_TO Patients
Subject
Continuous Positive Airway Pressure
Predicate
ADMINISTERED_TO
Object
Patients
4. Respiratory Distress Syndrom PROCESS_OF C0030705
Subject
Respiratory Distress Syndrom
Predicate
PROCESS_OF
Object
C0030705
5. Continuous Positive Airway Pressure TREATS Respiratory Distress Syndrom
Subject
Continuous Positive Airway Pressure
Predicate
TREATS
Object
Respiratory Distress Syndrom
6. Continuous Positive Airway Pressure TREATS Patients
Subject
Continuous Positive Airway Pressure
Predicate
TREATS
Object
Patients
7. COVID-19 CAUSES Respiratory Distress Syndrom
Subject
COVID-19
Predicate
CAUSES
Object
Respiratory Distress Syndrom
8. Pronation ASSOCIATED_WITH Respiratory Distress Syndrome, Adult
Subject
Pronation
Predicate
ASSOCIATED_WITH
Object
Respiratory Distress Syndrome, Adult
9. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
10. Continuous Positive Airway Pressure ADMINISTERED_TO Patients
Subject
Continuous Positive Airway Pressure
Predicate
ADMINISTERED_TO
Object
Patients
11. Respiratory Distress Syndrome, Adult PROCESS_OF Patients
Subject
Respiratory Distress Syndrome, Adult
Predicate
PROCESS_OF
Object
Patients
12. Continuous Positive Airway Pressure TREATS Respiratory Distress Syndrome, Adult
Subject
Continuous Positive Airway Pressure
Predicate
TREATS
Object
Respiratory Distress Syndrome, Adult
13. Continuous Positive Airway Pressure TREATS Patients
Subject
Continuous Positive Airway Pressure
Predicate
TREATS
Object
Patients
14. COVID-19 CAUSES Respiratory Distress Syndrome, Adult
Subject
COVID-19
Predicate
CAUSES
Object
Respiratory Distress Syndrome, Adult
ABSTRACT

BACKGROUND:

The efficacy and safety of continuous positive airway pressure and respiratory physiotherapy outside the Intensive Care Unit during a pandemic.

METHODS:

In this cohort study performed in February-May 2020 in a large teaching hospital in Milan, COVID-19 patients with adult respiratory distress syndrome receiving continuous positive airway pressure (positive end-expiratory pressure =10 cm H2O, FiO2=0.6, daily treatment duration 4×3h-cycles) and respiratory physiotherapy including pronation outside the Intensive Care Unit were followed-up.

RESULTS:

Of 90 acute respiratory distress syndrome (ARDS) patients treated with continuous positive airway pressure (45/90, 50% pronated at least once) outside the Intensive Care Unit and with a median (interquartile) follow-up of 37 (11-46) days, 45 (50%) were discharged at home, 28 (31%) were still hospitalized, and 17 (19%) died. Continuous positive airway pressure failure was recorded for 35 (39%) patients. Patient mobilization was associated with reduced failure rates (P=0.033). No safety issues were observed.

CONCLUSIONS:

Continuous positive airway pressure with patient mobilization (including pronation) was effective and safe in patients with ARDS due to COVID-19 managed outside the Intensive Care Unit setting during the pandemic.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / COVID-19 Type of study: Etiology study / Incidence study / Observational study / Risk factors Topics: Long Covid Limits: Adult / Humans Language: English Journal: Minerva Med Year: 2022 Document Type: Article Affiliation country: S0026-4806.20.06952-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / COVID-19 Type of study: Etiology study / Incidence study / Observational study / Risk factors Topics: Long Covid Limits: Adult / Humans Language: English Journal: Minerva Med Year: 2022 Document Type: Article Affiliation country: S0026-4806.20.06952-9