Clinical Findings and Outcomes From Subjects With COVID-19 Pneumonia in an Intermediate Respiratory Care Unit.
BACKGROUND: Many patients with COVID-19 require respiratory support and close monitoring. Intermediate respiratory care units (IRCU) may be valuable to optimally and adequately implement noninvasive respiratory support (NRS) to decrease clinical failure. We aimed at describing intubation and mortali...
| Publicado en: | Respiratory Care Vol. 68; no. 1; pp. 67 - 77 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Jan2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=160923590&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 160923590 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Jan2023 vid: 68 iid: 1 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 160923590 160923590 160923590 10.4187/respcare.10193 160923590 ppf: 67 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Clinical Findings and Outcomes From Subjects With COVID-19 Pneumonia in an Intermediate Respiratory Care Unit. aug: au: Laorden, Daniel Gholamian-Ovejero, Soraya Terán-Tinedo, José Rafael Lorente-González, Miguel Cano-Sanz, Eduardo Ortega-Fraile, María Ángeles Martínez-Alejos, Roberto Hernández-Nuñez, Joaquín De La Calle-Gil, Isabel Navarro-Casado, Rosalía Neria, Fernando Zevallos-Villegas, Annette Mariscal-Aguilar, Pablo Suarez-Ortiz, Miguel Plaza-Moreno, María Cristina Carballo-López, Daniel Gallego-Rodríguez, Berta Calderón-Alcala, Mariara Latif-Essa, Aylaf Churruca-Arróspide, María affil: Intermediate Respiratory Care Unit, Isabel Zendal Emergency Hospital, Madrid, Spain sug: subj: COVID-19 Therapy Pneumonia Therapy Respiratory Care Units Intubation Mortality Outcomes (Health Care) Spain Human Female Male Adult Middle Age Aged Aged, 80 and Over Retrospective Design Nonexperimental Studies Respiration, Artificial Cox Proportional Hazards Model Confidence Intervals Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Female Male ab: BACKGROUND: Many patients with COVID-19 require respiratory support and close monitoring. Intermediate respiratory care units (IRCU) may be valuable to optimally and adequately implement noninvasive respiratory support (NRS) to decrease clinical failure. We aimed at describing intubation and mortality in a novel facility entirely dedicated to COVID-19 and to establish their outcomes. METHODS: This was a retrospective, observational study performed at one hospital in Spain. We included consecutive subjects age > 18 y, admitted to IRCU with COVID-19 pneumonia, and requiring NRS between December 2020-September 2021. Data collected included mode and usage of NRS, laboratory findings, endotracheal intubation, and mortality at day 30. A multivariable Cox model was used to assess risk factors associated with clinical failure and mortality. RESULTS: A total of 1,306 subjects were included; 64.6% were male with mean age of 54.7 y. During the IRCU stay, 345 subjects clinically failed NRS (85.5% intubated; 14.5% died). Cox model showed a higher clinical failure in IRCU upon onset of symptoms and hospitalization was < 10 d (hazard ratio [HR] 1.59 [95% CI 1.24-2.03], P < .001) and PaO2 /FIO2 < 100 mm Hg (HR 1.59 [95% CI 1.27-1.98], P < .001). These variables were not associated with increased 30-d mortality. CONCLUSIONS: The IRCU was a valuable option to manage subjects with COVID-19 requiring NRS, thus reducing ICU overload. Male sex, gas exchange, and blood chemistry at admission were associated with worse prognosis, whereas older age, gas exchange, and blood chemistry were associated with 30-d mortality. These findings may provide a basis for better understanding outcomes and to improve management of noninvasively ventilated patients with COVID-19. pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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