Noninvasive ventilation for acute hypoxemic respiratory failure in patients with COVID-19

Sergey N Avdeev, Andrey I Yaroshetskiy, Natalia A Tsareva, Zamira M Merzhoeva, Natalia V Trushenko, Galina V Nekludova, Svetlana Yu Chikina, Sergey N Avdeev, Andrey I Yaroshetskiy, Natalia A Tsareva, Zamira M Merzhoeva, Natalia V Trushenko, Galina V Nekludova, Svetlana Yu Chikina

Abstract

Aim: Noninvasive ventilation (NIV) is known to reduce intubation in patients with acute hypoxemic respiratory failure (AHRF). We aimed to assess the outcomes of NIV application in COVID-19 patients with AHRF.

Materials & methods: In this retrospective cohort study, patients with confirmed diagnosis of COVID-19 and AHRF receiving NIV in general wards were recruited from two university-affiliated hospitals. Demographic, clinical, and laboratory data were recorded at admission. The failure of NIV was defined as intubation or death during the hospital stay.

Results: Between April 8 and June 10, 2020, 61 patients were enrolled into the final cohort. NIV was successful in 44 out of 61 patients (72.1%), 17 patients who failed NIV therapy were intubated, and among them 15 died. Overall mortality rate was 24.6%. Patients who failed NIV were older, and had higher respiratory rate, PaCO2, D-dimer levels before NIV and higher minute ventilation and ventilatory ratio on the 1-st day of NIV. No healthcare workers were infected with SARS-CoV-2 during the study period.

Conclusions: NIV is feasible in patients with COVID-19 and AHRF outside the intensive care unit, and it can be considered as a valuable option for the management of AHRF in these patients.

Keywords: Acute respiratory failure; COVID-19; Noninvasive ventilation.

Conflict of interest statement

Declaration of competing interest The authors have no competing interests to declare.

Copyright © 2020 Elsevier Inc. All rights reserved.

Figures

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Fig. 1
Study flow chart.

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Source: PubMed

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