Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective study

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 efficacy of these therapies has been studied in hospitalized patients with COVID-19, the clinical outcomes associated...

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Autores: Wendel-Garcia PD, Mas A, González-Isern C, Ferrer R, Máñez R, Masclans JR, Sandoval E, Vera P, Trenado J, Fernández R, Sirvent JM, Martínez M, Ibarz M, Garro P, Lopera JL, Bodí M, Yébenes-Reyes JC, Triginer C, Vallverdú I, Baró A, Bodí F, Saludes P, Valencia M, Roche-Campo F, Huerta A, Cambra FJ, Barberà C, Echevarria J, Peñuelas Ó, Mancebo J, UCIsCAT study group
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p20768
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20768
Access Level:acceso abierto
Palabra clave:COVID-19
Intensive care
Non-invasive oxygenation
Acute hypoxemic respiratory failure
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spelling Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective studyWendel-Garcia PDMas AGonzález-Isern CFerrer RMáñez RMasclans JRSandoval EVera PTrenado JFernández RSirvent JMMartínez MIbarz MGarro PLopera JLBodí MYébenes-Reyes JCTriginer CVallverdú IBaró ABodí FSaludes PValencia MRoche-Campo FHuerta ACambra FJBarberà CEchevarria JPeñuelas ÓMancebo JUCIsCAT study groupCOVID-19Intensive careNon-invasive oxygenationAcute hypoxemic respiratory failureBackground 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 efficacy of these therapies has been studied in hospitalized patients with COVID-19, the clinical outcomes associated with oxygen masks, high-flow oxygen 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 covariates 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-flow 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-flow 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-flow oxygen therapy by nasal cannula may be the approach of choice as the primary non-invasive oxygenation support strategy.BMC2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20768CRITICAL CAREISSN: 13648535ISSNe: 1466609Xreponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p207682026-05-27T12:37:41Z
dc.title.none.fl_str_mv Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective study
title Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective study
spellingShingle Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective study
Wendel-Garcia PD
COVID-19
Intensive care
Non-invasive oxygenation
Acute hypoxemic respiratory failure
title_short Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective study
title_full Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective study
title_fullStr Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective study
title_full_unstemmed Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective study
title_sort Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective study
dc.creator.none.fl_str_mv Wendel-Garcia PD
Mas A
González-Isern C
Ferrer R
Máñez R
Masclans JR
Sandoval E
Vera P
Trenado J
Fernández R
Sirvent JM
Martínez M
Ibarz M
Garro P
Lopera JL
Bodí M
Yébenes-Reyes JC
Triginer C
Vallverdú I
Baró A
Bodí F
Saludes P
Valencia M
Roche-Campo F
Huerta A
Cambra FJ
Barberà C
Echevarria J
Peñuelas Ó
Mancebo J
UCIsCAT study group
author Wendel-Garcia PD
author_facet Wendel-Garcia PD
Mas A
González-Isern C
Ferrer R
Máñez R
Masclans JR
Sandoval E
Vera P
Trenado J
Fernández R
Sirvent JM
Martínez M
Ibarz M
Garro P
Lopera JL
Bodí M
Yébenes-Reyes JC
Triginer C
Vallverdú I
Baró A
Bodí F
Saludes P
Valencia M
Roche-Campo F
Huerta A
Cambra FJ
Barberà C
Echevarria J
Peñuelas Ó
Mancebo J
UCIsCAT study group
author_role author
author2 Mas A
González-Isern C
Ferrer R
Máñez R
Masclans JR
Sandoval E
Vera P
Trenado J
Fernández R
Sirvent JM
Martínez M
Ibarz M
Garro P
Lopera JL
Bodí M
Yébenes-Reyes JC
Triginer C
Vallverdú I
Baró A
Bodí F
Saludes P
Valencia M
Roche-Campo F
Huerta A
Cambra FJ
Barberà C
Echevarria J
Peñuelas Ó
Mancebo J
UCIsCAT study group
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
Intensive care
Non-invasive oxygenation
Acute hypoxemic respiratory failure
topic COVID-19
Intensive care
Non-invasive oxygenation
Acute hypoxemic respiratory failure
description 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 efficacy of these therapies has been studied in hospitalized patients with COVID-19, the clinical outcomes associated with oxygen masks, high-flow oxygen 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 covariates 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-flow 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-flow 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-flow oxygen therapy by nasal cannula may be the approach of choice as the primary non-invasive oxygenation support strategy.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20768
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20768
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv CRITICAL CARE
ISSN: 13648535
ISSNe: 1466609X
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
reponame_str r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
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