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Cumulative oxygen deficit is a novel predictor for the timing of invasive mechanical ventilation in COVID-19 patients with respiratory distress.
Ge, Huiqing; Zhou, Jian-Cang; Lv, FangFang; Zhang, Junli; Yi, Jun; Yang, Changming; Zhang, Lingwei; Zhou, Yuhan; Ren, Binbin; Pan, Qing; Zhang, Zhongheng.
  • Ge H; Department of Respiratory Care, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Zhou JC; Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Lv F; Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Zhang J; Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Yi J; Thoracic Cardiovascular Surgery, Jingmen First People's Hospital, Hubei, China.
  • Yang C; Department of Anesthesiology, The First People's of Hospital of Jingmen City, Hubei, China.
  • Zhang L; College of Information Engineering, Zhejiang University of Technology, Hangzhou, China.
  • Zhou Y; College of Information Engineering, Zhejiang University of Technology, Hangzhou, China.
  • Ren B; Department of Infectious Disease, Jinhua Municipal Central Hospiltal, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China.
  • Pan Q; College of Information Engineering, Zhejiang University of Technology, Hangzhou, China.
  • Zhang Z; Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
PeerJ ; 8: e10497, 2020.
Article in English | MEDLINE | ID: covidwho-948184
ABSTRACT
BACKGROUND AND

OBJECTIVES:

The timing of invasive mechanical ventilation (IMV) is controversial in COVID-19 patients with acute respiratory hypoxemia. The study aimed to develop a novel predictor called cumulative oxygen deficit (COD) for the risk stratification.

METHODS:

The study was conducted in four designated hospitals for treating COVID-19 patients in Jingmen, Wuhan, from January to March 2020. COD was defined to account for both the magnitude and duration of hypoxemia. A higher value of COD indicated more oxygen deficit. The predictive performance of COD was calculated in multivariable Cox regression models.

RESULTS:

A number of 111 patients including 80 in the non-IMV group and 31 in the IMV group were included. Patients with IMV had substantially lower PaO2 (62 (49, 89) vs. 90.5 (68, 125.25) mmHg; p < 0.001), and higher COD (-6.87 (-29.36, 52.38) vs. -231.68 (-1040.78, 119.83) mmHg·day) than patients without IMV. As compared to patients with COD < 0, patients with COD > 30 mmHg·day had higher risk of fatality (HR 3.79, 95% CI [2.57-16.93]; p = 0.037), and those with COD > 50 mmHg·day were 10 times more likely to die (HR 10.45, 95% CI [1.28-85.37]; p = 0.029).

CONCLUSIONS:

The study developed a novel predictor COD which considered both magnitude and duration of hypoxemia, to assist risk stratification of COVID-19 patients with acute respiratory distress.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal: PeerJ Year: 2020 Document Type: Article Affiliation country: Peerj.10497

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal: PeerJ Year: 2020 Document Type: Article Affiliation country: Peerj.10497