Repositori URV

Identifier: imarina:9246565

Handle: https://hdl.handle.net/20.500.11797/imarina9246565

Authors:
Wendel-Garcia PDMas AGonzález-Isern CFerrer RMáñez RMasclans JRSandoval EVera PTrenado JFernández RSirvent JMMartínez MIbarz MGarro PLopera JLBodí MYébenes-Reyes JCTriginer CVallverdú IBaró ABodí FSaludes PValencia MRoche-Campo FHuerta ACambra FJBarberà CEchevarria JPeñuelas ÓMancebo JFerrer RRoca ONuvials XRuiz JCPapiol EMáñez RGumicio VDSandoval EMuñoz GToapanta DCastro POsorio JMasclans JRMuñoz-Bermúdez RParrilla FPérez-Teran PMarin-Corral JMas ACancio BHernández-Marín SKoborzan MRBriones CATrenado JFernández RSirvent JMSebastian PSaiz XMartínez MIbarz MGarro PPedrós CVendrell ELopera JLBodí MRodríguez AMoreno GYébenes-Reves JCTriginer CVallverdú IBaró AMorales MBodí FSaludes PCervelló JRValencia MRoche-Campo FFranch-Llasat DHuerta ASantigosa PCambra FJBenito SBarberà CEchevarría JMancebo JVera PSantos JABaldirà JBetbesé AJIzura MMorán ISuárez JCZapata LRodríguez NTorrens MCordón AGomila CFlores MSegarra AMorales MMateo LMartos M & González-Isern C

Abstract:
Background: Non-invasive oxygenation strategies have a prominent role in the treatment of acute hypoxemic respiratory failure during the coronavirus disease 2019 (COVID-19). While the efficacy of these therapies has been studied in hospitalized patients with COVID-19, the clinical outcomes associated with oxygen masks, high-flow oxygen therapy by nasal cannula and non-invasive mechanical ventilation in critically ill intensive care unit (ICU) patients remain unclear. Methods: In this retrospective study, we used the best of nine covariate balancing algorithms on all baseline covariates in critically ill COVID-19 patients supported with > 10 L of supplemental oxygen at one of the 26 participating ICUs in Catalonia, Spain, between March 14 and April 15, 2020. Results: Of the 1093 non-invasively oxygenated patients at ICU admission treated with one of the three stand-alone non-invasive oxygenation strategies, 897 (82%) required endotracheal intubation and 310 (28%) died during the ICU stay. High-flow oxygen therapy by nasal cannula (n = 439) and non-invasive mechanical ventilation (n = 101) were associated with a lower rate of endotracheal intubation (70% and 88%, respectively) than oxygen masks (n = 553 and 91% intubated), p < 0.001. Compared to oxygen masks, high-flow oxygen therapy by nasal cannula was associated with lower ICU mortality (hazard ratio 0.75 [95% CI 0.58–0.98), and the hazard ratio for ICU mortality was 1.21 [95% CI 0.80–1.83] for non-invasive mechanical ventilation. Conclusion: In critically ill COVID-19 ICU patients and, in the absence of conclusive data, high-flow oxygen therapy by nasal cannula may be the approach of choice as the primary non-invasive oxygenation support strategy.