| Title |
Predictors of noninvasive respiratory support failure in COVID‐19 patients: a prospective observational study / |
| Authors |
Zablockis, Rolandas ; Šlekytė, Goda ; Mereškevičienė, Rūta ; Kėvelaitienė, Karolina ; Zablockienė, Birutė ; Danila, Edvardas |
| DOI |
10.3390/medicina58060769 |
| Full Text |
|
| Is Part of |
Medicina.. Kaunas; Basel : LSMU ; MDPI. 2022, vol. 58, no. 6, art. no. 769, p. [1-12].. ISSN 1010-660X. eISSN 1648-9144 |
| Keywords [eng] |
acute hypoxemic respiratory failure ; COVID‐19 ; high‐flow nasal cannula ; non‐invasive ventilation ; predictive factor |
| Abstract [eng] |
Background and Objective: Respiratory assistance tactic that is best for COVID‐19‐associated acute hypoxemic respiratory failure (AHRF) individuals has yet to be determined. Patients with AHRF may benefit from the use of a high‐flow nasal cannula (HFNC) and non‐invasive ventilation (NIV). The goals of this prospective observational research were to estimate predictive factors for HFNC and NIV failure in COVID‐19‐related AHRF subjects. Materials and Methods: The research enlisted the participation of 124 patients. A stepwise treatment approach was used. HFNC and NIV were used on 124 (100%) and 64 (51.6%) patients, respectively. Thirty (24.2%) of 124 patients were intubated and received invasive mechanical ventilation. Results: 85 (68.5%) patients were managed successfully. Patients who required NIV exhibited a higher prevalence of treatment failure (70.3% vs. 51.6%, p = 0.019) and had higher mortality (59.4% vs. 31.5%, p = 0.001) than patients who received HFNC. Using logistic regression, the respiratory rate oxygenation (ROX) index at 24h (odds ratio (OR) = 0.74, p = 0.018) and the Charlson Comorbidity Index (CCI) (OR = 1.60, p = 0.003) were found to be predictors of HFNC efficacy. It was the ROX index at 24 h and the CCI optimum cut‐off values for HFNC outcome that were 6.1 (area under the curve (AUC) = 0.73) and 2.5 (AUC = 0.68), respectively. Serum ferritin level (OR = 0.23, p = 0.041) and lymphocyte count (OR = 1.03, p = 0.01) were confirmed as predictors of NIV failure. Serum ferritin level at a cut‐off value of 456.2 ng/mL (AUC = 0.67) and lymphocyte count lower than 0.70 per mm3, (AUC = 0.70) were associated with NIV failure with 70.5% sensitivity, 68.7% specificity and sensitivity of 84.1%, specificity of 56.2%, respectively. Conclusion: The ROX index at 24 h, CCI, as well as serum ferritin level, and lymphocyte count can be used as markers for HFNC and NIV failure, respectively, in SARS‐CoV‐2‐induced AHRF patients. |
| Published |
Kaunas; Basel : LSMU ; MDPI |
| Type |
Journal article |
| Language |
English |
| Publication date |
2022 |
| CC license |
|
