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ORIGINAL ARTICLE
Minerva Medica 2021 June;112(3):329-37
DOI: 10.23736/S0026-4806.21.07134-2
Copyright © 2021 EDIZIONI MINERVA MEDICA
language: English
Management of patients with severe acute respiratory failure due to SARS-CoV-2 pneumonia with noninvasive ventilatory support outside Intensive Care Unit
Teresa DIAZ DE TERAN 1, Monica GONZALES MARTINEZ 1, Paolo BANFI 2, Giancarlo GARUTI 3, Gianluca FERRAIOLI 4, Giuseppe RUSSO 4, Francesco CASU 4, Michela VIVARELLI 4, Monica BONFIGLIO 4, Alessandro PERAZZO 5, Cornelius BARLASCINI 6, Armando BAULEO 7, Antonello NICOLINI 5 ✉, Paolo SOLIDORO 8, 9
1 Unit of Pulmonary Sleep Disorders and Noninvasive Ventilation, Marqués de Valdecilla Hospital, Santander, Spain; 2 Unit of Rehabilitation Pulmonology, IRCCS Don Gnocchi Foundation, Milan, Italy; 3 Unit of Pulmonology, Santa Maria Bianca Hospital, Mirandola, Modena, Italy; 4 COVID Respiratory Intensive Care Unit, General Hospital, Sestri Levante, Genoa, Italy; 5 Unit of Respiratory Diseases, General Hospital, Sestri Levante, Genoa, Italy; 6 Unit of Hygiene and Health Care Medicine, General Hospital, Sestri Levante, Genoa, Italy; 7 Independent Scientific Consultant, Modena, Italy; 8 Unit of Respiratory Diseases, Department Cardiovascular and Thoracic Diseases, Città della Salute e della Scienza, Turin, Italy; 9 Department of Medical Science, University of Turin, Turin, Italy
BACKGROUND: COVID-19 has high mortality rate mainly stemming from acute respiratory distress leading to respiratory failure (ARF). Aim of the study was to evaluate the management of severe ARF due to COVID-19 pneumonia using noninvasive ventilatory support (NIVS), studying safety and effectiveness of NIVS.
METHODS: This is a retrospective, multicenter study. Primary outcomes were NIVS failure with intubation rate and hospital mortality. Secondary outcomes were hospital stay and factors related to NIVS failure and mortality. These outcomes were compared with patients intubated and admitted to ICU.
RESULTS: One hundred sixty-two patients were hospitalized because of severe respiratory failure (PaO
CONCLUSIONS: NIVS is a safe and effective strategy in the treatment of severe ARF due to COVID-19 related pneumonia, that reduces mortality and length of hospital stay in the carefully selected patients.
KEY WORDS: COVID-19; Respiratory insufficiency; Hospital mortality