Publication date: Sep 20, 2023
COVID-19 Acute Respiratory Distress Syndrome (CARDS) is the most serious complication of COVID-19. The SARS-CoV-2 outbreaks rapidly saturated intensive care unit (ICU), forcing the application of non-invasive respiratory support (NIRS) in respiratory intermediate care unit (RICU). The primary aim of this study is to compare the patients’ clinical characteristics and outcomes (Helmet-Continuous Positive Airway Pressure (H-CPAP) success/failure and survival/death). The secondary aim is to evaluate and detect the main predictors of H-CPAP success and survival/death. A total of 515 patients were enrolled in our observational prospective study based on CARDS developed in RICU during the three Italian pandemic waves. All selected patients were treated with H-CPAP. The worst ratio of arterial partial pressure of oxygen (PaO) and fraction of inspired oxygen (FiO) PaO/FiO during H-CPAP stratified the subjects into mild, moderate and severe CARDS. H-CPAP success has increased during the three waves (62%, 69% and 77%, respectively) and the mortality rate has decreased (28%, 21% and 13%). H-CPAP success/failure and survival/death were related to the PaO/FiO (worst score) ratio in H-CPAP and to steroids’ administration. D-dimer at admission, FiO and positive end expiratory pressure (PEEP) were also associated with H-CPAP success. Our study suggests good outcomes with H-CPAP in CARDS in RICU. A widespread use of steroids could play a role.
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| Concepts | Keywords |
|---|---|
| Covid | corticosteroids |
| Increased | COVID-19 ARDS |
| Italian | Helmet CPAP |
| Mortality | pulmonologist |
| Steroids | RICU |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 |
| disease | MESH | Acute Respiratory Distress Syndrome |
| drug | DRUGBANK | Spinosad |
| disease | MESH | death |
| drug | DRUGBANK | Oxygen |
| drug | DRUGBANK | Coenzyme M |
| disease | VO | dose |
| disease | VO | vaccination |
| disease | MESH | Acute hypoxemic respiratory failure |
| disease | MESH | interstitial pneumonia |
| drug | DRUGBANK | Ranitidine |
| disease | IDO | blood |
| disease | MESH | pneumonia |
| drug | DRUGBANK | Medical air |
| disease | MESH | lung injury |
| disease | MESH | Coma |
| disease | MESH | acidosis |
| disease | MESH | hypercapnia |
| disease | VO | organ |
| drug | DRUGBANK | Heparin |
| disease | VO | company |
| disease | VO | USA |
| disease | MESH | pulmonary embolism |
| disease | VO | ANOVA |
| disease | VO | time |
| disease | MESH | tumor |
| disease | MESH | chronic renal failure |
| disease | MESH | comorbidity |