A Questionnaire-Based Survey to Assess the Timing of Intubation in COVID-19 Pneumonia.

Abstract

BackgroundMany COVID19 pneumonia patients progress to Acute respiratory distress syndrome and end up in Intensive Care Units. Given that it is a novel viral infection, the progress of the disease, its management and associated outcomes are yet to be studied in detail. ARDS associated with COVID 19 is the same as before or different and the timing of intubation in such patients is a topic up for debate. This survey aimed to assess the opinion regarding management of COVID 19 ARDS and the timing of intubation in those patients.Methods292 clinicians including anesthesiologists, intensivists and others involved in managing COVID 19 ARDS patients at various centres were surveyed with web-based questionnaire cross sectionally within the time period of 10th June 2020 to 31st August 2020 after taking prior consent. Their responses were recorded and analyzed with statistical software IBM SPSS version 25.0.Results Among 292 included participants, 172 were intensivist, 84 were anesthesiologists and rest were others. Most of the intensivists (51.2%) had seen more than 100 COVID 19 severe ARDS patients. Around 82% of clinicians were agreed that COVID 19 ARDS was different from another form of ARDS. 67.1% of participants were agreed with patient induced self-inflicted injury could have happened in this disease. Likewise, around 91.8% of doctors involved in managing patients were believed that HFNC could be helpful if there were falling of saturation. 37% of participants were not agreed with early intubation, which may increase the risk of mortality and nosocomial infections.Conclusions and RelevanceThere was confusion in most doctors with intubation timing even if there was an indication for intubation. These confusions may be due to non-availability of specific recommendation regarding intubation in COVID 19 severe ARDS patients. However, most of the literature recommended for early intubation in these patients when indicated.