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Title: Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective study
Author: Wendel Garcia, Pedro David
Mas, Arantxa
González Isern, Cristina
Ferrer Roca, Ricard
Máñez Mendiluce, Rafael
Masclans, Joan Ramon
Sandoval, Elena
Vera Artazcoz, Paula
Trenado Álvarez, José
Fernández, Rafael
Sirvent, Josep Maria
Martínez, Melcior
Ibarz, Mercedes
Garro, Pau
Lopera, José Luis
Bodí, María
Yébenes Reyes, Juan Carles
Triginer, Carles
Vallverdú, Imma
Baró, Anna
Bodí, Fernanda
Saludes, Paula
Valencia, Mauricio
Roche Campo, Ferran
Huerta, Arturo
Cambra Lasaosa, Francisco José
Barberà, Carme
Echevarria, Jorge
Peñuelas, Oscar
Mancebo, Jordi
UCIsCAT study group
Keywords: COVID-19
Síndrome del destret respiratori de l'adult
Unitats de cures intensives
Teràpia respiratòria
Adult respiratory distress syndrome
Intensive care units
Oxygen therapy
Respiratory therapy
Issue Date: 8-Feb-2022
Publisher: BioMed Central
Abstract: Background: Non-invasive oxygenation strategies have a prominent role in the treatment of acute hypoxemic respiratory failure during the coronavirus disease 2019 (COVID-19). While the efcacy of these therapies has been studied in hospitalized patients with COVID-19, the clinical outcomes associated with oxygen masks, high-fow oxy‑ gen therapy by nasal cannula and non-invasive mechanical ventilation in critically ill intensive care unit (ICU) patients remain unclear. Methods: In this retrospective study, we used the best of nine covariate balancing algorithms on all baseline covari‑ ates in critically ill COVID-19 patients supported with>10 L of supplemental oxygen at one of the 26 participating ICUs in Catalonia, Spain, between March 14 and April 15, 2020. Results: Of the 1093 non-invasively oxygenated patients at ICU admission treated with one of the three stand-alone non-invasive oxygenation strategies, 897 (82%) required endotracheal intubation and 310 (28%) died during the ICU stay. High-fow oxygen therapy by nasal cannula (n=439) and non-invasive mechanical ventilation (n=101) were associated with a lower rate of endotracheal intubation (70% and 88%, respectively) than oxygen masks (n=553 and 91% intubated), p<0.001. Compared to oxygen masks, high-fow oxygen therapy by nasal cannula was associated with lower ICU mortality (hazard ratio 0.75 [95% CI 0.58-0.98), and the hazard ratio for ICU mortality was 1.21 [95% CI 0.80-1.83] for non-invasive mechanical ventilation. Conclusion: In critically ill COVID-19 ICU patients and, in the absence of conclusive data, high-fow oxygen therapy by nasal cannula may be the approach of choice as the primary non-invasive oxygenation support strategy
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It is part of: Critical Care, 2022, vol. 26, num. 1, p. 37
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ISSN: 1364-8535
Appears in Collections:Articles publicats en revistes (Medicina)

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