Respiratory support in COVID-19 patients in Kommunarka hospital: a single-centered, retrospective study
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Keywords

COVID-19
Critical Care
Respiratory Distress Syndrom
Mechanical Ventilation
Noninvasive Ventilation
Retrospective Studies

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Matiushkov NS, Tyurin IN, Avdeikin SN, Boyarkov AV, Kazakov DN, Kostin DM, Srednyakov AV, Protsenko DN Respiratory support in COVID-19 patients in Kommunarka hospital: a single-centered, retrospective study. Annals of Critical Care. 2021;(3):47–60. doi:10.21320/1818-474X-2021-3-47-60.

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Abstract

Introduction. During the SARS-CoV-2 pandemic, worldwide healthcare system faced a new, insufficiently investigated, fast-spreading disease with multisystem failure and relatively high amount of severe diseased. Existing evidence base needs to be frequently revisited after data accumulation and analysis. Experience of dedicated COVID-19 centers should be summarized and implicated in clinical practice according to evidence-based principles, extensive clinical trial initiation. Objectives. To investigate baseline characteristics and treatment outcomes of patients with severe SARS-CoV-2 infection course, requiring respiratory support in the critical care settings of dedicated hospital. Materials and methods. In single-center retrospective study retrospective data collection of 451 respiratory support for COVID-19 related acute respiratory distress syndrome cases (noninvasive ventilation, mechanical ventilation) in intensive care unit patients for a 5-month period performed. The analysis aimed on demographic, clinical data, disease severity scores, respiratory support parameters and modality, continuous renal replacement therapy utilization and interleukin-6 receptor blockers administration, survival rates. Results. Respiratory support required 48.8 % of intensive care unit patients, the population was demographically balanced, Charlson Comorbidity Index was 4.46 ± 2.6 and was higher in the mechanically ventilated group. 30-day survival rate (all respiratory support cases) was 33.7 %, mortality structure analysis performed. The disease severity scores, respiratory mechanics among patients in dependence of respiratory support mode and during the period of case registration analysed as well. Median static respiratory compliance at the point of initiation of invasive mechanically ventilation was 43 (IQR 35–51). Mortality in the volume controlled mechanically ventilated group was higher. Conclusions. The patients, requiring respiratory support, during intensive care unit stay have high comorbidity levels. Indications for non-invasive ventilation may be extended on patients with lower Charlson index and initial SOFA score, however, early recognition of high risk of noninvasive ventilation failure required. Volume control invasive ventilation associated with higher mortality levels despite comparable disease severity scores. Further investigation required.

https://doi.org/10.21320/1818-474X-2021-3-47-60
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References

  1. Gupta S., Hayek S.S., Wang W, et al. Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US [published online ahead of print, 2020 Jul 15] [published correction appears in DOI: 10.1001/jamainternmed.2020.4568]. JAMA Intern Med. 2020; 180(11): 1–12. DOI: 10.1001/jamainternmed.2020.3596
  2. Berlin D.A., Gulick R.M., Martinez F.J. Severe Covid-19. N Engl J Med. 2020; 383(25): 2451–60. DOI: 10.1056/NEJMcp2009575
  3. Acute Respiratory Distress Syndrome Network, Brower R.G., Matthay M.A., et al. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000; 342(18): 1301-8. DOI: 10.1056/NEJM200005043421801
  4. Временные методические рекомендации «Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19)» Версия 7 (03.06.2020). МЗРФ, 2020 г. [Vremennye metodicheskie rekomendacii «Profilaktika, diagnostika i lechenie novoj koronavirusnoj infekcii (COVID-19)» Versija 7 (03.06.2020) (In Russ)] Available from: https://static-0.rosminzdrav.ru/system/attachments/attaches/000/050/584/original/03062020_ %D0 %9CR_COVID-19_v7.pdf
  5. Gattinoni L., Coppola S., Cressoni M., et al. COVID-19 Does Not Lead to a «Typical» Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2020; 201(10): 1299–300. DOI: 10.1164/rccm.202003-0817LE
  6. Piraino T. Decremental PEEP titration: a step away from the table. Respir Care. 2013; 58(5): 886-8. DOI: 10.4187/respcare.02453
  7. Gattinoni L., Meissner K., Marini J.J. The baby lung and the COVID-19 era. Intensive Care Med. 2020; 46(7): 1438–40. DOI: 10.1007/s00134-020-06103-5
  8. Ye Z., Rochwerg B., Wang Y., et al. Treatment of patients with nonsevere and severe coronavirus disease 2019: an evidence-based guideline. CMAJ. 2020; 192(20): E536–E545. DOI: 10.1503/cmaj.200648
  9. Lazzeri M., Lanza A., Bellini R., et al. Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a Position Paper of the Italian Association of Respiratory Physiotherapists (ARIR). Monaldi Arch Chest Dis. 2020 Mar 26; 90(1). DOI: 10.4081/monaldi.2020.1285
  10. Nolan J.P., Monsieurs K.G., Bossaert L., et al. European Resuscitation Council COVID-19 guidelines executive summary. Resuscitation. 2020; 153: 45–55. DOI: 10.1016/j.resuscitation.2020.06.001
  11. Coppo A., Bellani G., Winterton D., et al. Feasibility and physiological effects of prone positioning in non-intubated patients with acute respiratory failure due to COVID-19 (PRON-COVID): a prospective cohort study. Lancet Respir Med. 2020; 8(8): 765–74. DOI: 10.1016/S2213-2600(20)30268-X
  12. Rochwerg B., Brochard L., Elliott M.W., et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J. 2017; 50(2): 1602426. DOI: 10.1183/13993003.02426-2016
  13. Carteaux G., Millán-Guilarte T., De Prost N., et al. Failure of Noninvasive Ventilation for De Novo Acute Hypoxemic Respiratory Failure: Role of Tidal Volume. Crit Care Med. 2016; 44(2): 282–90. DOI: 10.1097/CCM.0000000000001379
  14. Kim D.H., Park H.C., Cho A., et al. Age-adjusted Charlson comorbidity index score is the best predictor for severe clinical outcome in the hospitalized patients with COVID-19 infection. Medicine (Baltimore). 2021;100(18): e25900. DOI: 10.1097/MD.0000000000025900
  15. Tuty Kuswardhani R.A., Henrina J., Pranata R., et al. Charlson comorbidity index and a composite of poor outcomes in COVID-19 patients: A systematic review and meta-analysis. Diabetes Metab Syndr. 2020; 14(6): 2103–9. DOI: 10.1016/j.dsx.2020.10.022
  16. Gattinoni L., Chiumello D., Rossi S. COVID-19 pneumonia: ARDS or not? Crit Care. 2020; 24(1): 154. DOI: 10.1186/s13054-020-02880-z
  17. Gattinoni L., Coppola S., Cressoni M., et al. COVID-19 Does Not Lead to a “Typical” Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2020; 201(10): 1299–300. DOI: 10.1164/rccm.202003-0817LE
  18. Tsolaki V., Zakynthinos G.E., Makris D. The ARDSnet protocol may be detrimental in COVID-19. Crit Care. 2020; 24(1): 351. DOI: 10.1186/s13054-020-03081-4
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