Wendel Garcia, Pedro DavidMas, ArantxaGonzález Isern, CristinaFerrer Roca, RicardMáñez Mendiluce, RafaelMasclans, Joan RamonSandoval, ElenaVera Artazcoz, PaulaTrenado Álvarez, JoséFernández, RafaelSirvent, Josep MariaMartínez, MelciorIbarz, MercedesGarro, PauLopera, José LuisBodí, MaríaYébenes Reyes, Juan CarlesTriginer, CarlesVallverdú, ImmaBaró, AnnaBodí, FernandaSaludes, PaulaValencia, MauricioRoche Campo, FerranHuerta, ArturoCambra Lasaosa, Francisco JoséBarberà, CarmeEchevarria, JorgePeñuelas, OscarMancebo, JordiUCIsCAT study group2022-05-302022-05-302022-02-081364-8535https://hdl.handle.net/2445/186117Background: 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 strategy13 p.application/pdfengcc-by (c) Wendel Garcia, Pedro David et al., 2022https://creativecommons.org/licenses/by/4.0/COVID-19Síndrome del destret respiratori de l'adultUnitats de cures intensivesOxigenoteràpiaTeràpia respiratòriaNasCOVID-19Adult respiratory distress syndromeIntensive care unitsOxygen therapyRespiratory therapyNoseinfo:eu-repo/semantics/article7187892022-05-30info:eu-repo/semantics/openAccess35135588