Sistema de Salut de Catalunya
[Marti S, Sampol J, Pallero M, Ferrer J] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain. [Carsin AE] ISGlobal, Barcelona, Spain. Universitat Pompeu Fabra (UPF), Barcelona, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Aldas I, Marin T] Respiratory Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. [Tárrega J] Respiratory Department, Hospital General de Granollers, Granollers, Spain. Universitat Internacional de Catalunya, Barcelona, Spain. [Vélez Segovia E] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain
Hospital General de Granollers
2022-05-20T09:59:28Z
2022-05-20T09:59:28Z
2022-04-20
COVID-19; Noninvasive ventilation; High-flow oxygen
COVID-19; Ventilación no invasiva; Oxígeno de alto flujo
COVID-19; Ventilació no invasiva; Oxigen d'alt cabal
The effectiveness of noninvasive respiratory support in severe COVID-19 patients is still controversial. We aimed to compare the outcome of patients with COVID-19 pneumonia and hypoxemic respiratory failure treated with high-flow oxygen administered via nasal cannula (HFNC), continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV), initiated outside the intensive care unit (ICU) in 10 university hospitals in Catalonia, Spain. We recruited 367 consecutive patients aged ≥ 18 years who were treated with HFNC (155, 42.2%), CPAP (133, 36.2%) or NIV (79, 21.5%). The main outcome was intubation or death at 28 days after respiratory support initiation. After adjusting for relevant covariates and taking patients treated with HFNC as reference, treatment with NIV showed a higher risk of intubation or death (hazard ratio 2.01; 95% confidence interval 1.32-3.08), while treatment with CPAP did not show differences (0.97; 0.63-1.50). In the context of the pandemic and outside the intensive care unit setting, noninvasive ventilation for the treatment of moderate to severe hypoxemic acute respiratory failure secondary to COVID-19 resulted in higher mortality or intubation rate at 28 days than high-flow oxygen or CPAP. This finding may help physicians to choose the best noninvasive respiratory support treatment in these patients.Clinicaltrials.gov identifier: NCT04668196.
Article
Published version
English
COVID-19 (Malaltia); Insuficiència respiratòria; Terapèutica; DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections::Severe Acute Respiratory Syndrome; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Airway Management::Respiration, Artificial::Noninvasive Ventilation; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Airway Management::Intubation, Intratracheal; DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections; ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus::síndrome respiratorio agudo grave; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::manejo de la via aérea::respiración artificial::ventilación no invasiva; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::manejo de la via aérea::intubación endotraqueal; ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus
Nature Publishing Group
Scientific Reports;12
https://doi.org/10.1038/s41598-022-10475-7
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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