About: Salvage use of tissue plasminogen activator (tPA) in the setting of acute respiratory distress syndrome (ARDS) due to COVID-19 in the USA: a Markov decision analysis

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About: Salvage use of tissue plasminogen activator (tPA) in the setting of acute respiratory distress syndrome (ARDS) due to COVID-19 in the USA: a Markov decision analysis Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Salvage use of tissue plasminogen activator (tPA) in the setting of acute respiratory distress syndrome (ARDS) due to COVID-19 in the USA: a Markov decision analysis
Creator	Moore, Peter Barrett, Christopher Talmor, Daniel Choudhury, Rashikh Mcintyre, Robert Moore, Ernest Moore, Hunter Nydam, Trevor Yaffe, Michael
Source	Medline; PMC
abstract	BACKGROUND: COVID-19 threatens to quickly overwhelm our existing critical care infrastructure in the USA. Systemic tissue plasminogen activator (tPA) has been previously demonstrated to improve PaO(2)/FiO(2) (mmHg) when given to critically ill patients with acute respiratory distress syndrome (ARDS). It is unclear to what extent tPA may impact population-based survival during the current US COVID-19 pandemic. METHODS: A decision analytic Markov state transition model was created to simulate the life critically ill COVID-19 patients as they transitioned to either recovery or death. Two patient groups were simulated (50,000 patients in each group); (1) Patients received tPA immediately upon diagnosis of ARDS and (2) patients received standard therapy for ARDS. Base case critically ill COVID-19 patients were defined as having a refractory PaO(2)/FiO(2) of < 60 mmHg (salvage use criteria). Transition from severe to moderate to mild ARDS, recovery, and death were estimated. Markov model parameters were extracted from existing ARDS/COVID-19 literature. RESULTS: The use of tPA was associated with reduced mortality (47.6% [tTPA] vs. 71.0% [no tPA]) for base case patients. When extrapolated to the projected COVID-19 eligible for salvage use tPA in the USA, peak mortality (deaths/100,000 patients) was reduced for both optimal social distancing (70.5 [tPA] vs. 75.0 [no tPA]) and no social distancing (158.7 [tPA] vs. 168.8 [no tPA]) scenarios. CONCLUSIONS: Salvage use of tPA may improve recovery of ARDS patients, thereby reducing COVID-19-related mortality and ensuring sufficient resources to manage this pandemic.
has issue date	2020-04-20(xsd:dateTime)
bibo:doi	10.1186/s13017-020-00305-4
bibo:pmid	32312290
has license	cc-by
sha1sum (hex)	8fc88c41e39fc070e225580762354bdb7a155e03
schema:url	https://doi.org/10.1186/s13017-020-00305-4
resource representing a document's title	Salvage use of tissue plasminogen activator (tPA) in the setting of acute respiratory distress syndrome (ARDS) due to COVID-19 in the USA: a Markov decision analysis
has PubMed Central identifier	PMC7169373
has PubMed identifier	32312290
schema:publication	World J Emerg Surg
resource representing a document's body	covid:8fc88c41e39fc070e225580762354bdb7a155e03#body_text
is schema:about of	named entity 'tPA' named entity 'Systemic' named entity 'WHAT' named entity 'CRITICALLY ILL' named entity 'IMMEDIATELY' named entity 'MARKOV MODEL' named entity 'USA' named entity 'critically ill' named entity 'ARDS' named entity 'tPA' named entity 'salvage' named entity 'patients' named entity 'extent' named entity 'ARDS' named entity 'critically ill patients' named entity 'COVID-19 pandemic' named entity 'tPA' named entity 'COVID' named entity 'tPA' named entity 'refractory' named entity 'tPA' named entity 'standard normal distribution' named entity 'critical care' named entity 'tPA' named entity 'tPA' named entity 'ARDS' named entity 'ARDS' named entity 'probability' named entity 'ARDS' named entity 'ARDS' named entity 'fibrin' named entity 'social distancing' named entity 'Medical decision-making' named entity 'tPA' named entity 'tissue plasminogen activator' named entity 'state transition model' named entity 'ICU' named entity 'pulmonary function' named entity 'tPA' named entity 'phase I clinical trial' named entity 'social distancing' named entity 'tPA' named entity 'China' named entity 'decision model' named entity 'ICU' named entity 'tPA' named entity 'standard deviation' named entity 'Acute respiratory distress syndrome' named entity 'virus' named entity 'COVID' named entity 'ARDS' named entity 'ARDS' named entity 'tPA' named entity 'Mortality rate' named entity 'ARDS' named entity 'tPA' named entity 'ARDS' named entity 'tPA' named entity 'COVID-19 pandemic' named entity 'COVID' named entity 'ARDS' named entity 'COVID-19' named entity 'tPA' named entity 'ARDS' named entity 'COVID-19' named entity 'probability' named entity 'stroke' named entity 'tPA' named entity 'ARDS' named entity 'oxygen' named entity 'COVID' named entity 'ARDS' named entity 'ARDS'

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