Role of Intermediate Care Unit Admission and Noninvasive Respiratory Support during the COVID-19 Pandemic: A Retrospective Cohort Study.
Respiration
; 100(8): 786-793, 2021.
Artículo
en Inglés
| MEDLINE | ID: covidwho-1238620
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Este artículo de revista científica es probablemente basado en un preprint previamente disponible, por medio del reconocimiento de similitud realizado por una máquina. La confirmación humana aún está pendiente.
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Este artículo de revista científica es probablemente basado en un preprint previamente disponible, por medio del reconocimiento de similitud realizado por una máquina. La confirmación humana aún está pendiente.
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ABSTRACT
BACKGROUND:
The COVID-19 pandemic has led to shortage of intensive care unit (ICU) capacity. We developed a triage strategy including noninvasive respiratory support and admission to the intermediate care unit (IMCU). ICU admission was restricted to patients requiring invasive ventilation.OBJECTIVES:
The aim of this study is to describe the characteristics and outcomes of patients admitted to the IMCU.METHOD:
Retrospective cohort including consecutive patients admitted between March 28 and April 27, 2020. The primary outcome was the proportion of patients with severe hypoxemic respiratory failure avoiding ICU admission. Secondary outcomes included the rate of emergency intubation, 28-day mortality, and predictors of ICU admission.RESULTS:
One hundred fifty-seven patients with COVID-19-associated pneumonia were admitted to the IMCU. Among the 85 patients admitted for worsening respiratory failure, 52/85 (61%) avoided ICU admission. In multivariate analysis, PaO2/FiO2 (OR 0.98; 95% CI 0.96-0.99) and BMI (OR 0.88; 95% CI 0.78-0.98) were significantly associated with ICU admission. No death or emergency intubation occurred in the IMCU.CONCLUSIONS:
IMCU admission including standardized triage criteria, self-proning, and noninvasive respiratory support prevents ICU admission for a large proportion of patients with COVID-19 hypoxemic respiratory failure. In the context of the COVID-19 pandemic, IMCUs may play an important role in preserving ICU capacity by avoiding ICU admission for patients with worsening respiratory failure and allowing early discharge of ICU patients.Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Unidades de Cuidados Respiratorios
/
Insuficiencia Respiratoria
/
Ventilación no Invasiva
/
COVID-19
Tipo de estudio:
Estudio de cohorte
/
Estudio observacional
/
Estudio pronóstico
Tópicos:
Covid persistente
Límite:
Anciano
/
Femenino
/
Humanos
/
Masculino
/
Middle aged
País/Región como asunto:
Europa
Idioma:
Inglés
Revista:
Respiration
Año:
2021
Tipo del documento:
Artículo
País de afiliación:
000516329
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