COVID-19 management using respiratory supports in the ward, Australian hospital
Respirology
; 28(Supplement 2):219, 2023.
Article
in English
| EMBASE | ID: covidwho-2313264
ABSTRACT
Introduction/Aim:
Acute hypoxaemic respiratory failure occurs often in people with COVID-19 pneumonia, with high need for respiratory support therapies (RST). We aimed to examine the clinical management of COVID-19 pneumonia including use of ward-based RST. Method(s) A ambispective electronic medical record review was conducted at an Australian tertiary hospital for COVID-19 patients requiring ward-based RST between 28/02/2020 and 18/03/2022. Result(s) Of 964 patient records identified, 670 were included, with 61% male and mean age 62 years (SD=19). 344 (51.4%) were unvaccinated, with 120 (17.9%) having >=1respiratory comorbidities. Prone positional therapy was achieved in 63 (9.4%) and recommended in 221 (33%) patients. High flow nasal oxygen (HFNO;n = 243, 36.2%), continuous positive airway pressure (CPAP;n = 131, 19.5%) and non-invasive ventilation (NIV;n = 4, 0.6%) were frequently administered to patients. 120 (49.4%) patients received both HFNO and CPAP. Arterial blood gases were infrequently measured prior to initiation of HFNO (n = 23, 9.5%) or CPAP (n = 25,19.1%). Target saturation aims were documented in 547 (81.6%) patients with a medical prescription for RST in 486 (72.5%). Patients using HFNO/CPAP/NIV had a daily respiratory nurse consultant review 236 (97.1%) with documented RST prescriptions and aims. Medical verification occurred at least once per admission from a consultant or advanced trainee for 213 (87.6%) HFNO patients and 117 (89.3%) CPAP patients. Median usage of HFNO was 2 days (IQR 1-4) and for CPAP 1 days (IQR 0.5-3). The median length of stay was 5 days (IQR 3-8). Clinical escalation with transfer to ICU occurred in 90 (13.4%) patients, with 24 (26.6%) intubated. 44 (6.6%) patients died. Most (n = 424, 63.2%) were discharged directly home without requiring domiciliary respiratory supports. Conclusion(s) Multidisciplinary, ward-based RST was successfully provided to most patients with COVID-19 pneumonia with clear documentation of processes of care. Support for and expansion of ward-based RST models of care should be considered longer term. Conflict of Interest Nil.
adult; arterial blood; assisted ventilation; blood gas; comorbidity; conference abstract; conflict of interest; consultation; continuous positive airway pressure; controlled study; coronavirus disease 2019; documentation; drug therapy; electronic medical record; female; human; length of stay; major clinical study; male; middle aged; noninvasive ventilation; nurse consultant; prescription; tertiary care center; oxygen
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Respirology
Year:
2023
Document Type:
Article
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