About: Feasibility and clinical impact of out-of-ICU non-invasive respiratory support in patients with COVID-19 related pneumonia

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About: Feasibility and clinical impact of out-of-ICU non-invasive respiratory support in patients with COVID-19 related pneumonia Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Feasibility and clinical impact of out-of-ICU non-invasive respiratory support in patients with COVID-19 related pneumonia
Creator	Clini, Enrico Nava, Stefano Ranieri, V Vianello, Andrea Facciolongo, Nicola Guaraldi, Giovanni Guidelli, Luca Scala, Raffaele Tonelli, Roberto Arcaro, Giovanna Carlucci, Annalisa Dongilli, Roberto Franco, Cosimo Lastoria, Cinzia Malerba, Mario Nava, Negri, Alberto Pisani, Lara Schifino, Gioachino Spoladore, Greta Tabbi', Luca Tillio, Paolo
source	Medline; PMC
abstract	INTRODUCTION: The Coronavirus 2(SARS-CoV-2) outbreak spread rapidly in Italy and the lack of intensive care unit(ICU) beds soon became evident, forcing the application of noninvasive respiratory support(NRS) outside the ICU, raising concerns over staff contamination. We aimed to analyse the safety of the hospital staff, the feasibility, and outcomes of NRS applied to patients outside the ICU. METHODS: In this observational study, data from 670 consecutive patients with confirmed COVID-19 referred to the Pulmonology Units in nine hospitals between March 1st and May 10th,2020 were analysed. Data were collected including medication, mode and usage of the NRS (i.e. high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP), noninvasive ventilation(NIV)), length of stay in hospital, endotracheal intubation(ETI) and deaths. RESULTS: Forty-two health-care workers (11.4%) tested positive for infection, but only three of them required hospitalisation. Data are reported for all patients (69.3% male), whose mean age was 68 (sd 13) years. The PaO(2)/FiO(2) ratio at baseline was 152±79, and the majority of patients (49.3%) were treated with CPAP. The overall unadjusted 30-day mortality rate was 26.9% with 16%, 30%, and 30%, while the total ETI rate was 27% with 29%, 25% and 28%, for HFNC, CPAP, and NIV, respectively, and the relative probability to die was not related to the NRS used after adjustment for confounders. ETI and length of stay were not different among the groups. Mortality rate increased with age and comorbidity class progression. CONCLUSIONS: The application of NRS outside the ICU is feasible and associated with favourable outcomes. Nonetheless, it was associated with a risk of staff contamination.
has issue date	2020-08-03(xsd:dateTime)
bibo:doi	10.1183/13993003.02130-2020
bibo:pmid	32747398
has license	cc-by-nc
sha1sum (hex)	b01be64ab1df7d3380ea2265741fc2a3ea76e496
schema:url	https://doi.org/10.1183/13993003.02130-2020
resource representing a document's title	Feasibility and clinical impact of out-of-ICU non-invasive respiratory support in patients with COVID-19 related pneumonia
has PubMed Central identifier	PMC7397952
has PubMed identifier	32747398
schema:publication	Eur Respir J
resource representing a document's body	covid:b01be64ab1df7d3380ea2265741fc2a3ea76e496#body_text
is schema:about of	named entity 'CONTAMINATION' named entity 'OUTCOMES' named entity 'NONINVASIVE' named entity 'ARF' named entity 'Intubate' named entity 'Italy' named entity 'nasal cannula' named entity 'ICU beds' named entity 'contraindicate' named entity 'intubation' named entity 'intubated' named entity 'ICU' named entity 'COVID' named entity 'NIV' named entity 'confounders' named entity 'heterogeneity' named entity 'DNI' named entity 'prognosis' named entity 'CPAP' named entity 'intensivists' named entity 'PPE' named entity 'COVID-19' named entity 'mortality rate' named entity 'patients' named entity 'intensive care unit' named entity 'oxygen' named entity 'clinical outcomes' named entity 'polymerase chain reaction' named entity 'New Zealand' named entity 'contraindicated' named entity 'pulmonologists' named entity 'NIV' named entity 'ICU' named entity 'Hydroxychloroquine' named entity 'SARS-CoV-2' named entity 'health care workers' named entity 'sample size' named entity 'COVID' named entity 'pharyngeal' named entity 'monitoring systems' named entity 'COVID' named entity 'Hypertension' named entity 'Institutional Review Boards' named entity 'respiratory distress' named entity 'contamination' named entity 'Creative Commons' named entity 'Licence' named entity 'pneumonia' named entity 'intensive care unit' named entity 'ICU' named entity 'ICU' named entity 'ICU' named entity 'respiratory support' named entity 'non-invasive' named entity 'respiratory rate' named entity 'Coronavirus disease' named entity 'aerosol' named entity 'continuous positive airway pressure' named entity 'NIV' named entity 'air changes per hour'

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