Cargando…

Semiquantitative Chest CT Severity Score Predicts Failure of Noninvasive Positive-Pressure Ventilation in Patients Hospitalized for COVID-19 Pneumonia

OBJECTIVE: Noninvasive positive-pressure ventilation (NPPV) emerged as an efficient tool for treatment of COVID-19 pneumonia. The factors influencing NPPV failure still are elusive. The aim of the study was to investigate the relationships between semiquantitative chest computed tomography (CT) scor...

Descripción completa

Detalles Bibliográficos
Autores principales: Arcari, Luca, Ciolina, Federica, Cacciotti, Luca, Danti, Massimiliano, Camastra, Giovanni, Manzo, Daniele, Musarò, Salvatore, Pironi, Bruno, Marazzi, Giuseppe, Santini, Claudio, Ansalone, Gerardo, Sbarbati, Stefano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8434692/
https://www.ncbi.nlm.nih.gov/pubmed/34627709
http://dx.doi.org/10.1053/j.jvca.2021.09.010
_version_ 1783751659441094656
author Arcari, Luca
Ciolina, Federica
Cacciotti, Luca
Danti, Massimiliano
Camastra, Giovanni
Manzo, Daniele
Musarò, Salvatore
Pironi, Bruno
Marazzi, Giuseppe
Santini, Claudio
Ansalone, Gerardo
Sbarbati, Stefano
author_facet Arcari, Luca
Ciolina, Federica
Cacciotti, Luca
Danti, Massimiliano
Camastra, Giovanni
Manzo, Daniele
Musarò, Salvatore
Pironi, Bruno
Marazzi, Giuseppe
Santini, Claudio
Ansalone, Gerardo
Sbarbati, Stefano
author_sort Arcari, Luca
collection PubMed
description OBJECTIVE: Noninvasive positive-pressure ventilation (NPPV) emerged as an efficient tool for treatment of COVID-19 pneumonia. The factors influencing NPPV failure still are elusive. The aim of the study was to investigate the relationships between semiquantitative chest computed tomography (CT) scoring and NPPV failure and mortality in patients with COVID-19. DESIGN: Observational study. SETTING: Nonintensive care setting. PARTICIPANTS: A total of 112 patients consecutively admitted for COVID-19 pneumonia. INTERVENTIONS: Usual care including various degrees of respiratory support. MEASUREMENTS AND MAIN RESULTS: The semiquantitative CT score was calculated at hospital admission. Subgroups were identified according to the ventilation strategy used (oxygen delivered by Venturi mask n = 53; NPPV-responder n = 38; NPPV-failure n = 21). The study's primary endpoint was the use of NPPV. The secondary endpoints were NPPV failure and in-hospital death, respectively. CT score progressively increased among groups (six v nine v 14, p < 0.05 among all). CT score was an independent predictor of all study endpoints (primary endpoint: 1.25 [95% confidence interval {CI} 1.1-1.4], p = 0.001; NPPV failure: 1.41 [95% CI 1.18-1.69], p < 0.001; in-hospital mortality: 1.21 [95% CI 1.07-1.38], p = 0.003). According to receiver operator characteristics curve analysis, CT score was the most accurate variable for prediction of NPPV failure (area under the curve 0.862 with p < 0.001; p < 0.05 v other variables). CONCLUSIONS: The authors reported the common and effective use of NPPV in patients with COVID-19 pneumonia. In the authors’ population, a semiquantitative chest CT analysis at hospital admission accurately identified those patients responding poorly to NPPV.
format Online
Article
Text
id pubmed-8434692
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Elsevier Inc.
record_format MEDLINE/PubMed
spelling pubmed-84346922021-09-13 Semiquantitative Chest CT Severity Score Predicts Failure of Noninvasive Positive-Pressure Ventilation in Patients Hospitalized for COVID-19 Pneumonia Arcari, Luca Ciolina, Federica Cacciotti, Luca Danti, Massimiliano Camastra, Giovanni Manzo, Daniele Musarò, Salvatore Pironi, Bruno Marazzi, Giuseppe Santini, Claudio Ansalone, Gerardo Sbarbati, Stefano J Cardiothorac Vasc Anesth Original Article OBJECTIVE: Noninvasive positive-pressure ventilation (NPPV) emerged as an efficient tool for treatment of COVID-19 pneumonia. The factors influencing NPPV failure still are elusive. The aim of the study was to investigate the relationships between semiquantitative chest computed tomography (CT) scoring and NPPV failure and mortality in patients with COVID-19. DESIGN: Observational study. SETTING: Nonintensive care setting. PARTICIPANTS: A total of 112 patients consecutively admitted for COVID-19 pneumonia. INTERVENTIONS: Usual care including various degrees of respiratory support. MEASUREMENTS AND MAIN RESULTS: The semiquantitative CT score was calculated at hospital admission. Subgroups were identified according to the ventilation strategy used (oxygen delivered by Venturi mask n = 53; NPPV-responder n = 38; NPPV-failure n = 21). The study's primary endpoint was the use of NPPV. The secondary endpoints were NPPV failure and in-hospital death, respectively. CT score progressively increased among groups (six v nine v 14, p < 0.05 among all). CT score was an independent predictor of all study endpoints (primary endpoint: 1.25 [95% confidence interval {CI} 1.1-1.4], p = 0.001; NPPV failure: 1.41 [95% CI 1.18-1.69], p < 0.001; in-hospital mortality: 1.21 [95% CI 1.07-1.38], p = 0.003). According to receiver operator characteristics curve analysis, CT score was the most accurate variable for prediction of NPPV failure (area under the curve 0.862 with p < 0.001; p < 0.05 v other variables). CONCLUSIONS: The authors reported the common and effective use of NPPV in patients with COVID-19 pneumonia. In the authors’ population, a semiquantitative chest CT analysis at hospital admission accurately identified those patients responding poorly to NPPV. Elsevier Inc. 2022-08 2021-09-11 /pmc/articles/PMC8434692/ /pubmed/34627709 http://dx.doi.org/10.1053/j.jvca.2021.09.010 Text en © 2021 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Article
Arcari, Luca
Ciolina, Federica
Cacciotti, Luca
Danti, Massimiliano
Camastra, Giovanni
Manzo, Daniele
Musarò, Salvatore
Pironi, Bruno
Marazzi, Giuseppe
Santini, Claudio
Ansalone, Gerardo
Sbarbati, Stefano
Semiquantitative Chest CT Severity Score Predicts Failure of Noninvasive Positive-Pressure Ventilation in Patients Hospitalized for COVID-19 Pneumonia
title Semiquantitative Chest CT Severity Score Predicts Failure of Noninvasive Positive-Pressure Ventilation in Patients Hospitalized for COVID-19 Pneumonia
title_full Semiquantitative Chest CT Severity Score Predicts Failure of Noninvasive Positive-Pressure Ventilation in Patients Hospitalized for COVID-19 Pneumonia
title_fullStr Semiquantitative Chest CT Severity Score Predicts Failure of Noninvasive Positive-Pressure Ventilation in Patients Hospitalized for COVID-19 Pneumonia
title_full_unstemmed Semiquantitative Chest CT Severity Score Predicts Failure of Noninvasive Positive-Pressure Ventilation in Patients Hospitalized for COVID-19 Pneumonia
title_short Semiquantitative Chest CT Severity Score Predicts Failure of Noninvasive Positive-Pressure Ventilation in Patients Hospitalized for COVID-19 Pneumonia
title_sort semiquantitative chest ct severity score predicts failure of noninvasive positive-pressure ventilation in patients hospitalized for covid-19 pneumonia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8434692/
https://www.ncbi.nlm.nih.gov/pubmed/34627709
http://dx.doi.org/10.1053/j.jvca.2021.09.010
work_keys_str_mv AT arcariluca semiquantitativechestctseverityscorepredictsfailureofnoninvasivepositivepressureventilationinpatientshospitalizedforcovid19pneumonia
AT ciolinafederica semiquantitativechestctseverityscorepredictsfailureofnoninvasivepositivepressureventilationinpatientshospitalizedforcovid19pneumonia
AT cacciottiluca semiquantitativechestctseverityscorepredictsfailureofnoninvasivepositivepressureventilationinpatientshospitalizedforcovid19pneumonia
AT dantimassimiliano semiquantitativechestctseverityscorepredictsfailureofnoninvasivepositivepressureventilationinpatientshospitalizedforcovid19pneumonia
AT camastragiovanni semiquantitativechestctseverityscorepredictsfailureofnoninvasivepositivepressureventilationinpatientshospitalizedforcovid19pneumonia
AT manzodaniele semiquantitativechestctseverityscorepredictsfailureofnoninvasivepositivepressureventilationinpatientshospitalizedforcovid19pneumonia
AT musarosalvatore semiquantitativechestctseverityscorepredictsfailureofnoninvasivepositivepressureventilationinpatientshospitalizedforcovid19pneumonia
AT pironibruno semiquantitativechestctseverityscorepredictsfailureofnoninvasivepositivepressureventilationinpatientshospitalizedforcovid19pneumonia
AT marazzigiuseppe semiquantitativechestctseverityscorepredictsfailureofnoninvasivepositivepressureventilationinpatientshospitalizedforcovid19pneumonia
AT santiniclaudio semiquantitativechestctseverityscorepredictsfailureofnoninvasivepositivepressureventilationinpatientshospitalizedforcovid19pneumonia
AT ansalonegerardo semiquantitativechestctseverityscorepredictsfailureofnoninvasivepositivepressureventilationinpatientshospitalizedforcovid19pneumonia
AT sbarbatistefano semiquantitativechestctseverityscorepredictsfailureofnoninvasivepositivepressureventilationinpatientshospitalizedforcovid19pneumonia