Your browser doesn't support javascript.
loading
Comparison of high-flow nasal therapy, noninvasive ventilation, and continuous positive airway pressure on outcomes in critically ill patients admitted for COVID-19 with acute respiratory failure.
Chelly, Jonathan; Coupry, Louis-Marie; van Phach Vong, Ly; Kamel, Toufik; Marzouk, Mehdi; Terzi, Nicolas; Bruel, Cedric; Autret, Aurélie; Garnero, Aude; Arnal, Jean-Michel.
Afiliação
  • Chelly J; Intensive Care Unit, Centre Hospitalier Intercommunal Toulon La Seyne sur Mer, Sainte Musse Hospital, Toulon, France - jonathan.chelly@ch-toulon.fr.
  • Coupry LM; Intensive Care Unit, Groupe Hospitalier Sud Ile de France, Melun, France.
  • van Phach Vong L; Intensive Care Unit, Grand Hôpital de l'Est Francilien (GHEF), Jossigny, France.
  • Kamel T; Intensive Care Unit, Centre Hospitalier Régional (CHR) d'Orléans, Orléans, France.
  • Marzouk M; Intensive Care Unit, Hospital of Béthune, Béthune, France.
  • Terzi N; Intensive Care Unit, Centre Hospitalier Universitaire (CHU) de Grenoble, Grenoble, France.
  • Bruel C; Intensive Care Unit, Saint Joseph Hospital, Paris, France.
  • Autret A; Clinical Research Department, Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer - Sainte Musse Hospital, Toulon, France.
  • Garnero A; Intensive Care Unit, Centre Hospitalier Intercommunal Toulon La Seyne sur Mer, Sainte Musse Hospital, Toulon, France.
  • Arnal JM; Intensive Care Unit, Centre Hospitalier Intercommunal Toulon La Seyne sur Mer, Sainte Musse Hospital, Toulon, France.
Minerva Anestesiol ; 89(1-2): 66-73, 2023.
Article em En | MEDLINE | ID: mdl-36448989
BACKGROUND: The optimal first-line noninvasive respiratory support (NIRS) to improve outcome in patients affected by COVID-19 pneumonia admitted to ICU is still debated. METHODS: We conducted a retrospective study in seven French ICUs, including all adults admitted between July and December 2020 with documented SARS-CoV-2 acute respiratory failure (PaO2/FiO2<300 mmHg), and treated with either high-flow nasal therapy (HFNT) alone, noninvasive ventilation alone or in combination with HFNT (NIV), or continuous positive airway pressure alone or in combination with HFNT (CPAP). The primary outcome was NIRS failure at day 28, defined as the need for endotracheal intubation (ETI) or death without ETI. RESULTS: Among the 355 patients included, 160 (45%) were treated with HFNT alone, 115 (32%) with NIV and 80 (23%) with CPAP. The primary outcome occurred in 65 (41%), 69 (60%), and 25 (31%) patients among those treated with HFNT alone, NIV, and CPAP, respectively (P<0.001). After univariate analysis, patients treated with CPAP had a trend for a lower incidence of the primary outcome, whereas patients treated with NIV had a significant higher incidence of the primary outcome, both compared to those treated with HFNT alone (unadjusted Hazard ratio 0.67; 95% CI [0.42-1.06], and 1.58; 95% CI [1.12-2.22]; P=0.09 and 0.008, respectively). CONCLUSIONS: Among ICU patients admitted for severe COVID-19 pneumonia and managed with NIRS, the outcome seems to differ according to the initial chosen strategy. Prospective randomized controlled studies are warranted to identify the optimal strategy.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Síndrome do Desconforto Respiratório / Insuficiência Respiratória / Ventilação não Invasiva / COVID-19 Tipo de estudo: Clinical_trials / Observational_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Síndrome do Desconforto Respiratório / Insuficiência Respiratória / Ventilação não Invasiva / COVID-19 Tipo de estudo: Clinical_trials / Observational_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article