The Use of High-Flow Nasal Cannula and Non-Invasive Mechanical Ventilation in the Management of COVID-19 Patients: A Prospective Study.
The Use of High-Flow Nasal Cannula and Non-Invasive Mechanical Ventilation in the Management of COVID-19 Patients: A Prospective Study.
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DOI：
10.3390/v15091879
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发表时间：
2023-09-05
期刊：
影响因子：
--
通讯作者：
Mahesh PA
中科院分区：
文献类型：
--
作者：
Arunachala S;Parthasarathi A;Basavaraj CK;Malamardi S;Chandran S;Venkataraman H;Ullah MK;Ganguly K;Upadhyay S;Mahesh PA
高流量鼻插管（HFNC）和呼吸机输送的无创机械通气（NIV）被用于治疗COVID-19肺炎引起的急性呼吸窘迫综合征（ARDS），特别是在低收入和中等收入国家（LMIC），因为缺乏呼吸机和人力资源，尽管缺乏有关其疗效的数据。这项前瞻性研究旨在分析HFNC与NIV在COVID-19 ARDS治疗中的疗效。共招募了88名经RT-PCR证实的COVID-19中度ARDS患者。使用线性回归和广义估计方程（GEE）分析生命参数随时间的趋势。共有37名患者接受HFNC，51名患者接受NIV。HFNC组患者在ICU的停留时间略长于NIV组患者，但无显著差异（HFNC vs. NIV：8.00（4.0-12.0）天vs. 7.00（2.0-12.0）天; p = 0.055）。两组的插管率、并发症和死亡率相似。从NIV转换为HFNC的占5.8%，而37.8%需要从HFNC转换为NIV。NIV治疗呼吸道阻塞效果较好。我们得出结论，在COVID-19肺炎伴中度ARDS患者中，使用HFNC或NIV进行呼吸支持的ICU治疗持续时间、插管率和死亡率无显著差异。
High-flow nasal cannula (HFNC) and ventilator-delivered non-invasive mechanical ventilation (NIV) were used to treat acute respiratory distress syndrome (ARDS) due to COVID-19 pneumonia, especially in low- and middle-income countries (LMICs), due to lack of ventilators and manpower resources despite the paucity of data regarding their efficacy. This prospective study aimed to analyse the efficacy of HFNC versus NIV in the management of COVID-19 ARDS. A total of 88 RT-PCR-confirmed COVID-19 patients with moderate ARDS were recruited. Linear regression and generalized estimating equations (GEEs) were used for trends in vital parameters over time. A total of 37 patients were on HFNC, and 51 were on NIV. Patients in the HFNC group stayed slightly but not significantly longer in the ICU as compared to their NIV counterparts (HFNC vs. NIV: 8.00 (4.0–12.0) days vs. 7.00 (2.0–12.0) days; p = 0.055). Intubation rates, complications, and mortality were similar in both groups. The switch to HFNC from NIV was 5.8%, while 37.8% required a switch to NIV from HFNC. The resolution of respiratory alkalosis was better with NIV. We conclude that in patients with COVID-19 pneumonia with moderate ARDS, the duration of treatment in the ICU, intubation rate, and mortality did not differ significantly with the use of HFNC or NIV for respiratory support.
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影响因子：
2.3
作者：
Costa WNDS;Miguel JP;Prado FDS;Lula LHSM;Amarante GAJ;Righetti RF;Yamaguti WP
通讯作者：
Yamaguti WP
影响因子：
38.9
作者：
COVID-ICU Group on behalf of the REVA Network and the COVID-ICU Investigators
通讯作者：
COVID-ICU Group on behalf of the REVA Network and the COVID-ICU Investigators
影响因子：
3.7
作者：
Wang Z;Wang Z
通讯作者：
Wang Z
影响因子：
7.1
作者：
Nishimura M
通讯作者：
Nishimura M
DOI：
10.2147/copd.s206111
发表时间：
2019-01-01
影响因子：
2.8
作者：
Braeunlich, Jens;Dellweg, Dominic;Wirtz, Hubert
通讯作者：
Wirtz, Hubert