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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
Semantic information from SemMedBD (by NLM)
1. Invasive mechanical ventilation NOS TREATS Respiratory distress
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
Respiratory distress
2. Invasive mechanical ventilation NOS TREATS COVID-19
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
COVID-19
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
4. Respiratory distress PROCESS_OF Patients
Subject
Respiratory distress
Predicate
PROCESS_OF
Object
Patients
5. Invasive mechanical ventilation NOS TREATS Patients
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
Patients
6. Invasive mechanical ventilation NOS TREATS Hypoxemia
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
Hypoxemia
7. Hypoxemia PROCESS_OF Patients
Subject
Hypoxemia
Predicate
PROCESS_OF
Object
Patients
8. Hospitals LOCATION_OF Study
Subject
Hospitals
Predicate
LOCATION_OF
Object
Study
9. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Patients
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Patients
10. Acute respiratory distress PROCESS_OF Patients
Subject
Acute respiratory distress
Predicate
PROCESS_OF
Object
Patients
11. Invasive mechanical ventilation NOS TREATS Respiratory distress
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
Respiratory distress
12. Invasive mechanical ventilation NOS TREATS COVID-19
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
COVID-19
13. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
14. Respiratory distress PROCESS_OF Patients
Subject
Respiratory distress
Predicate
PROCESS_OF
Object
Patients
15. Invasive mechanical ventilation NOS TREATS Patients
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
Patients
16. Invasive mechanical ventilation NOS TREATS Hypoxemia
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
Hypoxemia
17. Hypoxemia PROCESS_OF Patients
Subject
Hypoxemia
Predicate
PROCESS_OF
Object
Patients
18. Hospitals LOCATION_OF Study
Subject
Hospitals
Predicate
LOCATION_OF
Object
Study
19. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Patients
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Patients
20. Acute respiratory distress PROCESS_OF Patients
Subject
Acute respiratory distress
Predicate
PROCESS_OF
Object
Patients
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.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Language: English Journal: PeerJ Clinical aspect: Etiology / Prediction / Prognosis Year: 2020

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Language: English Journal: PeerJ Clinical aspect: Etiology / Prediction / Prognosis Year: 2020
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