Evaluating the Newly Proposed ARDS Definition in Hospitalized Patients With COVID-19 Treated With High-Flow Nasal Oxygen.
Background: The new Global definition of ARDS recently introduced a subgroup known as non-intubated ARDS. This study aimed to assess the risk of progression from noninvasive oxygen support to intubation and ARDS severity based on the SpO2/FIO2 among non-intubated subjects with ARDS. Methods: This re...
| Publicado en: | Respiratory Care Vol. 70; no. 2; pp. 119 - 126 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | CEU research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Feb2025
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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=182642157&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 182642157 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Feb2025 vid: 70 iid: 2 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 182642157 182642157 182642157 10.4187/respcare.11933 182642157 ppf: 119 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Evaluating the Newly Proposed ARDS Definition in Hospitalized Patients With COVID-19 Treated With High-Flow Nasal Oxygen. aug: au: Isha, Shahin Olaizola, Gustavo Carboni Bisso, Indalecio Raavi, Lekhya Jonna, Sadhana Jenkins, Anna Hanson, Abby Kashyap, Rahul Monzon, Veronica Huespe, Ivan A. Sanghavi, Devang affil: Drs Isha, Raavi, Jonna, and Sanghavi and Mss Jenkins and Hanson are affiliated with Mayo Clinic, Jacksonville, Florida. sug: subj: Respiratory Distress Syndrome, Acute Diagnosis Respiratory Distress Syndrome, Acute Therapy Hospitalization COVID-19 Therapy Oxygen Therapy Nasal Cannula Intubation, Intratracheal Severity of Illness Evaluation Oxygen Saturation Evaluation Risk Assessment Reference Values Time Treatment Outcomes Human Education, Continuing (Credit) Inpatients Retrospective Design Record Review Multicenter Studies Argentina Hospital Mortality Evaluation Critical Care Prospective Studies Florida Arizona Minnesota Wisconsin Kaplan-Meier Estimator Descriptive Statistics Data Analysis Software Middle Age Aged Confidence Intervals Male Female Comparative Studies Length of Stay APACHE (Acute Physiology and Chronic Health Evaluation) Clinical Assessment Tools Respiratory Distress Syndrome, Acute Mortality COVID-19 Mortality Respiratory Distress Syndrome, Acute Prognosis COVID-19 Prognosis Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: The new Global definition of ARDS recently introduced a subgroup known as non-intubated ARDS. This study aimed to assess the risk of progression from noninvasive oxygen support to intubation and ARDS severity based on the SpO2/FIO2 among non-intubated subjects with ARDS. Methods: This retrospective study included subjects with COVID-19 admitted to 7 hospitals (5 in the United States and 2 in Argentina) from January 2020–January 2023. Subjects meeting the new non-intubated ARDS definition (high-flow nasal cannula [HFNC] with an SpO2/FIO2 ≤315 [with SpO2 ≤97%] or a PaO2/FIO2 ≤300 mm Hg while receiving ≥30 L/min O2 via HFNC) were included. The study evaluated the proportion of subjects who progressed to intubation, severity levels using the SpO2/FIO2 cutoff proposed in the new ARDS definition, and mortality. Results: Nine hundred sixty-five non-intubated subjects with ARDS were included, of whom 27% (n = 262) progressed to meet the Berlin criteria within a median of 3 d (interquartile range 2–6). The overall mortality was 23% (95% CI 20–26) (n = 225), and among subjects who progressed to the Berlin criteria, it was 37% (95% CI 31–43) (n = 98). Additionally, the worst SpO2/FIO2 within 1 d of ARDS diagnosis was correlated with mortality, with mortality rates of 26% (95% CI 23–30) (n = 177) for subjects with SpO2/FIO2 ≤148, 17% (95% CI 12–23) (n = 38) for those with SpO2/FIO2 between 149–234, and 16% (95% CI 8–28) (n = 10) for subjects maintaining an SpO2/FIO2 higher than 235 (P < .001). Conclusions: The non-intubated ARDS criteria encompassed a broader spectrum of subjects with lower in-hospital mortality compared to the Berlin criteria. The SpO2/FIO2 and ARDS severity cutoff proposed in the new Global ARDS definition were valuable predictors of in-hospital mortality in these subjects. pubtype: Academic Journal doctype: CEU research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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