COVID-19 Acute Respiratory Distress Syndrome: Treatment with Helmet CPAP in Respiratory Intermediate Care Unit by Pulmonologists in the Three Italian Pandemic Waves.

IF 1.8 Q3 RESPIRATORY SYSTEM Advances in respiratory medicine Pub Date : 2023-09-20 DOI:10.3390/arm91050030
Martina Piluso, Clarissa Ferrari, Silvia Pagani, Pierfranco Usai, Stefania Raschi, Luca Parachini, Elisa Oggionni, Chiara Melacini, Francesca D'Arcangelo, Roberta Cattaneo, Cristiano Bonacina, Monica Bernareggi, Serena Bencini, Marta Nadalin, Mara Borelli, Roberto Bellini, Maria Chiara Salandini, Paolo Scarpazza
{"title":"COVID-19 Acute Respiratory Distress Syndrome: Treatment with Helmet CPAP in Respiratory Intermediate Care Unit by Pulmonologists in the Three Italian Pandemic Waves.","authors":"Martina Piluso,&nbsp;Clarissa Ferrari,&nbsp;Silvia Pagani,&nbsp;Pierfranco Usai,&nbsp;Stefania Raschi,&nbsp;Luca Parachini,&nbsp;Elisa Oggionni,&nbsp;Chiara Melacini,&nbsp;Francesca D'Arcangelo,&nbsp;Roberta Cattaneo,&nbsp;Cristiano Bonacina,&nbsp;Monica Bernareggi,&nbsp;Serena Bencini,&nbsp;Marta Nadalin,&nbsp;Mara Borelli,&nbsp;Roberto Bellini,&nbsp;Maria Chiara Salandini,&nbsp;Paolo Scarpazza","doi":"10.3390/arm91050030","DOIUrl":null,"url":null,"abstract":"<p><p>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<sub>2</sub>) and fraction of inspired oxygen (FiO<sub>2</sub>) PaO<sub>2</sub>/FiO<sub>2</sub> 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<sub>2</sub>/FiO<sub>2</sub> (worst score) ratio in H-CPAP and to steroids' administration. D-dimer at admission, FiO<sub>2</sub> 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.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"91 5","pages":"383-396"},"PeriodicalIF":1.8000,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514851/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in respiratory medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3390/arm91050030","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0

Abstract

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 (PaO2) and fraction of inspired oxygen (FiO2) PaO2/FiO2 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 PaO2/FiO2 (worst score) ratio in H-CPAP and to steroids' administration. D-dimer at admission, FiO2 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.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
新冠肺炎急性呼吸窘迫综合征:肺科医生在三次意大利大流行病浪潮中在呼吸中间监护室使用头盔CPAP治疗。
新冠肺炎急性呼吸窘迫综合征(CARDS)是新冠肺炎最严重的并发症。严重急性呼吸系统综合征冠状病毒2型疫情迅速使重症监护室(ICU)饱和,迫使无创呼吸支持(NIRS)在呼吸中间监护室(RICU)中应用。本研究的主要目的是比较患者的临床特征和结果(头盔持续气道正压通气(H-CPAP)的成功/失败和生存/死亡)。次要目的是评估和检测H-CPAP成功和生存/死亡的主要预测因素。根据意大利三波疫情期间RICU开发的CARDS,共有515名患者参与了我们的观察性前瞻性研究。所有入选患者均接受H-CPAP治疗。H-CPAP期间动脉血氧分压(PaO2)和吸入氧分数(FiO2)的最差比率PaO2/FiO2将受试者分为轻度、中度和重度CARDS。H-CPAP的成功率在三波中分别增加了62%、69%和77%,死亡率下降了28%、21%和13%。H-CPAP的成功/失败和生存/死亡与H-CPAP中的PaO2/FiO2(最差分数)比率和类固醇的给药有关。入院时的D-二聚体、FiO2和呼气末正压(PEEP)也与H-CPAP的成功相关。我们的研究表明H-CPAP在RICU的CARDS中有良好的效果。类固醇的广泛使用可能起到一定作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Advances in respiratory medicine
Advances in respiratory medicine RESPIRATORY SYSTEM-
CiteScore
2.60
自引率
0.00%
发文量
90
期刊介绍: "Advances in Respiratory Medicine" is a new international title for "Pneumonologia i Alergologia Polska", edited bimonthly and addressed to respiratory professionals. The Journal contains peer-reviewed original research papers, short communications, case-reports, recommendations of the Polish Respiratory Society concerning the diagnosis and treatment of lung diseases, editorials, postgraduate education articles, letters and book reviews in the field of pneumonology, allergology, oncology, immunology and infectious diseases. "Advances in Respiratory Medicine" is an open access, official journal of Polish Society of Lung Diseases, Polish Society of Allergology and National Research Institute of Tuberculosis and Lung Diseases.
期刊最新文献
Association Between Weight-Adjusted Waist Index and Emphysema in Adults in the United States: A Cross-Sectional Study Involving 44,949 Participants. Beneficial Impact of Vaccination Against SARS-CoV-2 on the Mental Health of IPF Patients. 2024 Update on Position Statement by Experts from the Polish Society of Allergology and the Polish Respiratory Society on the Evaluation of Efficacy and Effectiveness of Single Inhaler Triple Therapies in Asthma Treatment. Application of Forced Oscillation Technique in Assessing Pulmonary Fibrosis in Hermansky-Pudlak Syndrome. Expression of Epithelial Alarmin Receptor on Innate Lymphoid Cells Type 2 in Eosinophilic Chronic Obstructive Pulmonary Disease.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1