دورية أكاديمية
Use of Inhaled Epoprostenol in Patients With COVID-19 Receiving Humidified, High-Flow Nasal Oxygen Is Associated With Progressive Respiratory Failure.
| العنوان: | Use of Inhaled Epoprostenol in Patients With COVID-19 Receiving Humidified, High-Flow Nasal Oxygen Is Associated With Progressive Respiratory Failure. |
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| المؤلفون: | Michelson AP; Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO.; Department of Medicine, the Institute for Informatics, Washington University School of Medicine, Saint Louis, MO., Lyons PG; Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO., Nguyen NM; Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO., Reynolds D; Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO., McDonald R; Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO., McEvoy CA; Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO., Despotovic V; Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO., Brody SL; Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO., Kollef MH; Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO., Kraft BD; Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO. |
| المصدر: | CHEST critical care [CHEST Crit Care] 2023 Dec; Vol. 1 (3). Date of Electronic Publication: 2023 Sep 25. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier, Inc Country of Publication: United States NLM ID: 9918681585806676 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2949-7884 (Electronic) Linking ISSN: 29497884 NLM ISO Abbreviation: CHEST Crit Care Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [New York] : Elsevier, Inc., [2023]- |
| مستخلص: | Background: The clinical benefit of using inhaled epoprostenol (iEpo) through a humidified high-flow nasal cannula (HHFNC) remains unknown for patients with COVID-19. Research Question: Can iEpo prevent respiratory deterioration for patients with positive SARS-CoV-2 findings receiving HHFNC? Study Design and Methods: This multicenter retrospective cohort analysis included patients aged 18 years or older with COVID-19 pneumonia who required HHFNC treatment. Patients who received iEpo were propensity score matched to patients who did not receive iEpo. The primary outcome was time to mechanical ventilation or death without mechanical ventilation and was assessed using Kaplan-Meier curves and Cox proportional hazard ratios. The effects of residual confounding were assessed using a multilevel analysis, and a secondary analysis adjusted for outcome propensity also was performed in a multivariable model that included the entire (unmatched) patient cohort. Results: Among 954 patients with positive SARS-CoV-2 findings receiving HHFNC therapy, 133 patients (13.9%) received iEpo. After propensity score matching, the median number of days until the composite outcome was similar between treatment groups (iEpo: 5.0 days [interquartile range, 2.0-10.0 days] vs no-iEpo: 6.5 days [interquartile range, 2.0-11.0 days]; P = .26), but patients who received iEpo were more likely to meet the composite outcome in the propensity score-matched, multilevel, and multivariable unmatched analyses (hazard ratio, 2.08 [95% CI, 1.73-2.50]; OR, 4.72 [95% CI, 3.01-7.41]; and OR, 1.35 [95% CI, 1.23-1.49]; respectively). Interpretation: In patients with COVID-19 receiving HHFNC therapy, use of iEpo was associated with the need for invasive mechanical ventilation. |
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| معلومات مُعتمدة: | KL2 TR002346 United States TR NCATS NIH HHS; U01 TR003528 United States TR NCATS NIH HHS; UL1 TR002345 United States TR NCATS NIH HHS |
| فهرسة مساهمة: | Keywords: ARDS; Acute respiratory distress syndrome; COVID-19; SARS-CoV-2; humidified high-flow nasal cannula; inhaled epoprostenol; inhaled pulmonary vasodilators |
| تواريخ الأحداث: | Date Created: 20240322 Latest Revision: 20240324 |
| رمز التحديث: | 20240324 |
| مُعرف محوري في PubMed: | PMC10956404 |
| DOI: | 10.1016/j.chstcc.2023.100019 |
| PMID: | 38516615 |
| قاعدة البيانات: | MEDLINE |
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