التفاصيل البيبلوغرافية
| العنوان: |
Predictors of failure with high-flow nasal oxygen therapy in COVID-19 patients with acute respiratory failure: a multicenter observational study. |
| المؤلفون: |
Mellado-Artigas, Ricard, Mujica, Luis Eduardo, Ruiz, Magda Liliana, Ferreyro, Bruno Leonel, Angriman, Federico, Arruti, Egoitz, Torres, Antoni, Barbeta, Enric, Villar, Jesús, Ferrando, Carlos, for the COVID-19 Spanish ICU Network, Vendrell, Marina, Sánchez-Etayo, Gerard, Alcón, Amalia, Belda, Isabel, Agustí, Mercé, Carramiñana, Albert, Gracia, Isabel, Panzeri, Miriam, León, Irene |
| المصدر: |
Journal of Intensive Care; 3/5/2021, Vol. 9 Issue 1, p1-9, 9p |
| مصطلحات موضوعية: |
ADULT respiratory distress syndrome, COVID-19 treatment, OXYGEN therapy, INTENSIVE care units, COVID-19 |
| مستخلص: |
Purpose: We aimed to describe the use of high-flow nasal oxygen (HFNO) in patients with COVID-19 acute respiratory failure and factors associated with a shift to invasive mechanical ventilation. Methods: This is a multicenter, observational study from a prospectively collected database of consecutive COVID-19 patients admitted to 36 Spanish and Andorran intensive care units (ICUs) who received HFNO on ICU admission during a 22-week period (March 12-August 13, 2020). Outcomes of interest were factors on the day of ICU admission associated with the need for endotracheal intubation. We used multivariable logistic regression and mixed effects models. A predictive model for endotracheal intubation in patients treated with HFNO was derived and internally validated. Results: From a total of 259 patients initially treated with HFNO, 140 patients (54%) required invasive mechanical ventilation. Baseline non-respiratory Sequential Organ Failure Assessment (SOFA) score [odds ratio (OR) 1.78; 95% confidence interval (CI) 1.41-2.35], and the ROX index calculated as the ratio of partial pressure of arterial oxygen to inspired oxygen fraction divided by respiratory rate (OR 0.53; 95% CI: 0.37-0.72), and pH (OR 0.47; 95% CI: 0.24-0.86) were associated with intubation. Hospital site explained 1% of the variability in the likelihood of intubation after initial treatment with HFNO. A predictive model including non-respiratory SOFA score and the ROX index showed excellent performance (AUC 0.88, 95% CI 0.80-0.96). Conclusions: Among adult critically ill patients with COVID-19 initially treated with HFNO, the SOFA score and the ROX index may help to identify patients with higher likelihood of intubation. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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