Efficacy and Safety of High PEEP NIV in COVID-19 Patients.

IF 1.9 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Disaster Medicine and Public Health Preparedness Pub Date : 2024-05-30 DOI:10.1017/dmp.2024.85

Ivan Šitum, Lovro Hrvoić, Gloria Mamić, Nikolina Džaja, Zvonimir Popović, Nikica Karković, Ivan Jurković, Ante Erceg, Vedran Premužić, Mirabel Mažar, Slobodan Mihaljević, Romana Perković, Dora Karmelić, Daniel Lovrić

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引用次数: 0

Abstract

Objective: To investigate the efficacy and safety of non-invasive ventilation (NIV) with high PEEP levels application in patients with COVID-19-related acute respiratory distress syndrome (ARDS).

Methods: This is a retrospective cohort study with data collected from 95 patients who were administered NIV as part of their treatment in the COVID-19 intensive care unit (ICU) at University Hospital Centre Zagreb between October 2021 and February 2022. The definite outcome was NIV failure.

Results: High PEEP NIV was applied in all 95 patients; 54 (56.84%) patients could be kept solely on NIV, while 41 (43.16%) patients required intubation. ICU mortality of patients solely on NIV was 3.70%, while total ICU mortality was 35.79%. The most significant difference in the dynamic of respiratory parameters between 2 patient groups was visible on Day 3 of ICU stay: By that day, patients kept solely on NIV required significantly lower PEEP levels and had better improvement in PaO₂, P/F ratio, and HACOR score.

Conclusion: High PEEP applied by NIV was a safe option for the initial respiratory treatment of all patients, despite the severity of ARDS. For some patients, it was also shown to be the only necessary form of oxygen supplementation.

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高 PEEP NIV 在 COVID-19 患者中的有效性和安全性。

目的研究在 COVID-19 相关急性呼吸窘迫综合征（ARDS）患者中应用高 PEEP 水平无创通气（NIV）的有效性和安全性：这是一项回顾性队列研究，收集了 2021 年 10 月至 2022 年 2 月期间在萨格勒布大学医院中心 COVID-19 重症监护室（ICU）接受 NIV 治疗的 95 名患者的数据。明确的结果是 NIV 失败：所有 95 名患者均使用了高 PEEP NIV；54 名（56.84%）患者可以完全依靠 NIV，而 41 名（43.16%）患者需要插管。仅使用 NIV 的患者的 ICU 死亡率为 3.70%，而 ICU 总死亡率为 35.79%。两组患者呼吸参数动态的最明显差异出现在入住重症监护室的第 3 天：到了第三天，仅使用 NIV 的患者所需的 PEEP 水平明显降低，PaO2、P/F 比值和 HACOR 评分也有更好的改善：结论：尽管 ARDS 的严重程度不同，但在所有患者的初始呼吸治疗中，使用 NIV 进行高 PEEP 是一种安全的选择。结论：尽管 ARDS 的病情严重，但在所有患者的初始呼吸治疗中，高 PEEP 是一种安全的选择，对于某些患者来说，它也被证明是唯一必要的氧气补充方式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Disaster Medicine and Public Health Preparedness PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.40

自引率

7.40%

发文量

258

审稿时长

6-12 weeks

期刊介绍： Disaster Medicine and Public Health Preparedness is the first comprehensive and authoritative journal emphasizing public health preparedness and disaster response for all health care and public health professionals globally. The journal seeks to translate science into practice and integrate medical and public health perspectives. With the events of September 11, the subsequent anthrax attacks, the tsunami in Indonesia, hurricane Katrina, SARS and the H1N1 Influenza Pandemic, all health care and public health professionals must be prepared to respond to emergency situations. In support of these pressing public health needs, Disaster Medicine and Public Health Preparedness is committed to the medical and public health communities who are the stewards of the health and security of citizens worldwide.