Clinical outcomes of moderate to severe COVID-19 patients receiving invasive vs. non-invasive ventilation
Objective: To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit (HDU) in relation to invasive vs. non-invasive mode of ventilation. Methods: In this study, the patients required either non-invasive [oxygen ≤10 L/min or >10 L/min through mask...
Published in: | Asian Pacific Journal of Tropical Medicine |
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Wolters Kluwer Medknow Publications
2021
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Online Access: | https://doi.org/10.4103/1995-7645.312518 https://doaj.org/article/b7d8f2c35a5448b49b3a5ac1bd3a26b4 |
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ftdoajarticles:oai:doaj.org/article:b7d8f2c35a5448b49b3a5ac1bd3a26b4 2023-05-15T15:11:13+02:00 Clinical outcomes of moderate to severe COVID-19 patients receiving invasive vs. non-invasive ventilation Zubia Jamil Samreen Khalid Shahid Mumtaz Abbasi Yasir Waheed Jamal Ahmed 2021-01-01T00:00:00Z https://doi.org/10.4103/1995-7645.312518 https://doaj.org/article/b7d8f2c35a5448b49b3a5ac1bd3a26b4 EN eng Wolters Kluwer Medknow Publications http://www.apjtm.org/article.asp?issn=1995-7645;year=2021;volume=14;issue=4;spage=176;epage=182;aulast=Jamil https://doaj.org/toc/2352-4146 2352-4146 doi:10.4103/1995-7645.312518 https://doaj.org/article/b7d8f2c35a5448b49b3a5ac1bd3a26b4 Asian Pacific Journal of Tropical Medicine, Vol 14, Iss 4, Pp 176-182 (2021) covid-19 sars-cov-2 non-invasive ventilation respiratory insufficiency hypoxia mechanical ventilation Arctic medicine. Tropical medicine RC955-962 article 2021 ftdoajarticles https://doi.org/10.4103/1995-7645.312518 2022-12-30T20:39:23Z Objective: To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit (HDU) in relation to invasive vs. non-invasive mode of ventilation. Methods: In this study, the patients required either non-invasive [oxygen ≤10 L/min or >10 L/min through mask or nasal prongs, rebreather masks and bilevel positive airway pressure (BiPAP)] or invasive ventilation. For analysis of 30-day in hospital mortality in relation to use of different modes of oxygen, Kaplan Meier and log rank analyses were used. In the end, independent predictors of survival were determined by Cox regression analysis. Results: Invasive ventilation was required by 15.1% patients while 84.9% patients needed non-invasive ventilation. Patients with evidence of thromboembolism, high inflammatory markers and hypoxemia mainly required invasive ventilation. The 30-day in hospital mortality was 72.7% for the invasive group and 12.9% for the non-invasive group (1.8% oxygen <10 L/min, 0.9% oxygen >10 L/min, 3.6% rebreather mask and 4.5% BiPAP). The median time from hospital admission to outcome was 7 days for the invasive group and 18 days for the non-invasive group (P<0.05). Age, presence of co-morbidities, number of days requiring oxygen, rebreather, BiPAP and invasive ventilation were independent predictors of outcome. Conclusions: Invasive mechanical ventilation is associated with adverse outcomes possibly due to ventilator associated lung injury. Thus, protective non-invasive ventilation remains the necessary and safe treatment for severely hypoxic COVID-19 patients. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Meier ENVELOPE(-45.900,-45.900,-60.633,-60.633) Asian Pacific Journal of Tropical Medicine 14 4 176 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
covid-19 sars-cov-2 non-invasive ventilation respiratory insufficiency hypoxia mechanical ventilation Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
covid-19 sars-cov-2 non-invasive ventilation respiratory insufficiency hypoxia mechanical ventilation Arctic medicine. Tropical medicine RC955-962 Zubia Jamil Samreen Khalid Shahid Mumtaz Abbasi Yasir Waheed Jamal Ahmed Clinical outcomes of moderate to severe COVID-19 patients receiving invasive vs. non-invasive ventilation |
topic_facet |
covid-19 sars-cov-2 non-invasive ventilation respiratory insufficiency hypoxia mechanical ventilation Arctic medicine. Tropical medicine RC955-962 |
description |
Objective: To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit (HDU) in relation to invasive vs. non-invasive mode of ventilation. Methods: In this study, the patients required either non-invasive [oxygen ≤10 L/min or >10 L/min through mask or nasal prongs, rebreather masks and bilevel positive airway pressure (BiPAP)] or invasive ventilation. For analysis of 30-day in hospital mortality in relation to use of different modes of oxygen, Kaplan Meier and log rank analyses were used. In the end, independent predictors of survival were determined by Cox regression analysis. Results: Invasive ventilation was required by 15.1% patients while 84.9% patients needed non-invasive ventilation. Patients with evidence of thromboembolism, high inflammatory markers and hypoxemia mainly required invasive ventilation. The 30-day in hospital mortality was 72.7% for the invasive group and 12.9% for the non-invasive group (1.8% oxygen <10 L/min, 0.9% oxygen >10 L/min, 3.6% rebreather mask and 4.5% BiPAP). The median time from hospital admission to outcome was 7 days for the invasive group and 18 days for the non-invasive group (P<0.05). Age, presence of co-morbidities, number of days requiring oxygen, rebreather, BiPAP and invasive ventilation were independent predictors of outcome. Conclusions: Invasive mechanical ventilation is associated with adverse outcomes possibly due to ventilator associated lung injury. Thus, protective non-invasive ventilation remains the necessary and safe treatment for severely hypoxic COVID-19 patients. |
format |
Article in Journal/Newspaper |
author |
Zubia Jamil Samreen Khalid Shahid Mumtaz Abbasi Yasir Waheed Jamal Ahmed |
author_facet |
Zubia Jamil Samreen Khalid Shahid Mumtaz Abbasi Yasir Waheed Jamal Ahmed |
author_sort |
Zubia Jamil |
title |
Clinical outcomes of moderate to severe COVID-19 patients receiving invasive vs. non-invasive ventilation |
title_short |
Clinical outcomes of moderate to severe COVID-19 patients receiving invasive vs. non-invasive ventilation |
title_full |
Clinical outcomes of moderate to severe COVID-19 patients receiving invasive vs. non-invasive ventilation |
title_fullStr |
Clinical outcomes of moderate to severe COVID-19 patients receiving invasive vs. non-invasive ventilation |
title_full_unstemmed |
Clinical outcomes of moderate to severe COVID-19 patients receiving invasive vs. non-invasive ventilation |
title_sort |
clinical outcomes of moderate to severe covid-19 patients receiving invasive vs. non-invasive ventilation |
publisher |
Wolters Kluwer Medknow Publications |
publishDate |
2021 |
url |
https://doi.org/10.4103/1995-7645.312518 https://doaj.org/article/b7d8f2c35a5448b49b3a5ac1bd3a26b4 |
long_lat |
ENVELOPE(-45.900,-45.900,-60.633,-60.633) |
geographic |
Arctic Meier |
geographic_facet |
Arctic Meier |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Asian Pacific Journal of Tropical Medicine, Vol 14, Iss 4, Pp 176-182 (2021) |
op_relation |
http://www.apjtm.org/article.asp?issn=1995-7645;year=2021;volume=14;issue=4;spage=176;epage=182;aulast=Jamil https://doaj.org/toc/2352-4146 2352-4146 doi:10.4103/1995-7645.312518 https://doaj.org/article/b7d8f2c35a5448b49b3a5ac1bd3a26b4 |
op_doi |
https://doi.org/10.4103/1995-7645.312518 |
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Asian Pacific Journal of Tropical Medicine |
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14 |
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4 |
container_start_page |
176 |
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1766342104730042368 |