Noninvasive respiratory support for COVID-19 patients: when, for whom, and how?
Zachary P. Sullivan,Luca Zazzeron,Lorenzo Berra,Dean R. Hess,Edward A. Bittner,Marvin G. Chang +5 more
TLDR
In this paper , an algorithm for noninvasive respiratory support (NIRS) in COVID-19 patients with mild respiratory disease and prior pandemics is proposed. But, the authors do not consider the potential negative effects of NIRS on patients with more advanced respiratory disease.Abstract:
The significant mortality rate and prolonged ventilator days associated with invasive mechanical ventilation (IMV) in patients with severe COVID-19 have incited a debate surrounding the use of noninvasive respiratory support (NIRS) (i.e., HFNC, CPAP, NIV) as a potential treatment strategy. Central to this debate is the role of NIRS in preventing intubation in patients with mild respiratory disease and the potential beneficial effects on both patient outcome and resource utilization. However, there remains valid concern that use of NIRS may prolong time to intubation and lung protective ventilation in patients with more advanced disease, thereby worsening respiratory mechanics via self-inflicted lung injury. In addition, the risk of aerosolization with the use of NIRS has the potential to increase healthcare worker (HCW) exposure to the virus. We review the existing literature with a focus on rationale, patient selection and outcomes associated with the use of NIRS in COVID-19 and prior pandemics, as well as in patients with acute respiratory failure due to different etiologies (i.e., COPD, cardiogenic pulmonary edema, etc.) to understand the potential role of NIRS in COVID-19 patients. Based on this analysis we suggest an algorithm for NIRS in COVID-19 patients which includes indications and contraindications for use, monitoring recommendations, systems-based practices to reduce HCW exposure, and predictors of NIRS failure. We also discuss future research priorities for addressing unanswered questions regarding NIRS use in COVID-19 with the goal of improving patient outcomes. read more
Citations
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Effect of High Altitude on the Survival of COVID-19 Patients in Intensive Care Unit: A Cohort Study
Manuel Jibaja,Estefania Roldan-Vasquez,Jordi Rello,Hua Shen,Nelson Maldonado,Michelle Grunauer,Ana Maria Diaz,Fernanda García,Vanessa Ramirez,Hernán Sánchez,José Barberán,Juan Paredes,Mónica Cevallos,Francisco Montenegro,S. Puertas,Killen Briones,M. Martínez,Jorge Luis Vélez-Páez,Mario Montalvo-Villagómez,L. Herrera,Santiago Garrido,Ivan Sisa +21 more
TL;DR: Patients treated at high altitude at any time point during the study period were 74% more likely to experience ICU survival/discharge and 35% morelikely to experience hospital survival/ Discharge than to the sea-level group.
Journal ArticleDOI
Clinical update on COVID-19 for the emergency clinician: Airway and resuscitation
Summer A Chavez,William J. Brady,Michael S. Gottlieb,Brandon M Carius,Stephen Y. Liang,Alex Koyfman,Brit Long +6 more
TL;DR: In this paper , a narrative review provides emergency clinicians with a focused update of the resuscitation and airway management of the coronavirus disease of 2019 (COVID-19) patients.
Journal ArticleDOI
The HACOR Score Predicts Worse in-Hospital Prognosis in Patients Hospitalized with COVID-19
Massimo Raffaele Mannarino,Vanessa Bianconi,E. Cosentini,Filippo Figorilli,Costanza Natali,Giulia Cellini,Cecilia Colangelo,Francesco Giglioni,Marco Braca,Matteo Pirro +9 more
TL;DR: The HACOR score is a significant predictor of adverse clinical outcomes in patients with COVID-19-related ARF, and is associated with the need for intubation or in-hospital death in the whole population and subgroup.
Journal ArticleDOI
Clinical Characteristics and Outcomes of Patients with Acute Respiratory Failure Due to SARS-CoV-2 Interstitial Pneumonia Treated with CPAP in a Medical Intermediate Care Setting: A Retrospective Observational Study on Comparison of Four Waves
Silvia Accordino,Ciro Canetta,G. Bettini,Federica Corsico,Gabriele Ghigliazza,L. Barbetta,Christian Folli,Valeria Savojardo,Francesco Blasi +8 more
TL;DR: In this article , the authors compared the characteristics of patients admitted to a Medical Intermediate Care Unit for acute respiratory failure due to SARS-CoV-2 pneumonia throughout four pandemic waves.
Journal ArticleDOI
The efficiency of high-flow nasal cannula for adult patients with coronavirus disease 19 in Jeddah, Saudi Arabia
Majid S Al-Thaqafy,Saleh Jamaan Alzahrani,Abdulwahab Ghormalah Alghamdi,Saleh Alselemi,Khalid Ali Alshebani,Bussma Ahmed Bugis,Alaa A Bugis,Ali S Al-Shareef +7 more
TL;DR: There might be a promising intervention for HFNC to prevent the risk of intubation and decrease the mortality rate, according to the success rate of HFNC, which was considered a positive outcome.
References
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TL;DR: In selected immunosuppressed patients with pneumonitis and acute respiratory failure, early initiation of noninvasive ventilation is associated with significant reductions in the rates of endotracheal intubation and serious complications and an improved likelihood of survival to hospital discharge.
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