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Determinants of Increased Effort of Breathing in Non-Intubated Critical COVID-19 Patients.
Vicka, Vaidas; Januskeviciute, Elija; Krauklyte, Justina; Aleknaviciene, Aiste; Ringaitiene, Donata; Jancoriene, Ligita; Sipylaite, Jurate.
  • Vicka V; Clinic of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania.
  • Januskeviciute E; Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania.
  • Krauklyte J; Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania.
  • Aleknaviciene A; Clinic of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania.
  • Ringaitiene D; Clinic of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania.
  • Jancoriene L; Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania.
  • Sipylaite J; Clinic of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania.
Medicina (Kaunas) ; 58(8)2022 Aug 21.
Article in English | MEDLINE | ID: covidwho-1997706
ABSTRACT
Background and

objectives:

Acute respiratory distress syndrome (ARDS) is the most common complication occurring in COVID-19 patients admitted to the ICU. Given the increased respiratory work of these patients, it is necessary to evaluate their actual breathing efforts. The aim of this study is to report the incidence and determinants of increased effort of breathing (EOB) in critical COVID-19 patients. Materials and

Methods:

This was a retrospective study of COVID-19 patients admitted to the ICU during the year of 2020. Respiratory rate (RR) was chosen as an indicator of EOB. The cut-off value was set at more than 20 breaths per minute. ROC-AUC analysis was performed to identify the accuracy of the PaO2 and PaCO2 to determine increased EOB. Furthermore, multivariate regression analysis was performed to reveal the determinants of increased EOB.

Results:

213 patients were included in the study. Mean RR in the population was 24.20 ± 6.28. 138 (64.8%) of the patients had increased EOB. The ROC-AUC analysis revealed the PaO2 (0.656 (CI 95% 0.579-0.734, p < 0.001) as more accurate predictor of EOB than PaCO2 (0.584 (CI 95% 0.505-0.662, p = 0.043). In the final multivariate model, the SpO2 (exp(B) = 0.922, CI 95% 0.874-0.97 p = 0.033), PaO2/FiO2 ratio (exp(B) = 0.996, CI 95% 0.922-1.000, p = 0.003) and PaO2 (exp(B) = 0.989 CI 95% 0.982-0.996 p = 0.003) prevailed as independent predictors of increased EOB.

Conclusions:

To conclude, PaO2 was revealed as a more accurate predictor of increased EOB than PaCO2. Further investigation revealed the independent determinants of EOB blood oxygen saturation, PaO2 and PaO2/FiO2 ratio.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: Medicina58081133

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: Medicina58081133