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Letter to the Editor: “Use of inhaled epoprostenol with high flow nasal oxygen in non-intubated patients with severe COVID-19”
PURPOSE: Acute lung injury associated with COVID-19 contributes significantly to its morbidity and mortality. Though invasive mechanical ventilation is sometimes necessary, the use of high flow nasal oxygen may avoid the need for mechanical ventilation in some patients. For patients approaching the...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8863404/ https://www.ncbi.nlm.nih.gov/pubmed/35217371 http://dx.doi.org/10.1016/j.jcrc.2022.153989 |
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author | Chiles, Joe W. Vijaykumar, Kadambari Darby, Adrienne Goetz, Ryan L. Kane, Lauren E. Methukupally, Abhishek R. Gandotra, Sheetal Russell, Derek W. Whitson, Micah R. Kelmenson, Daniel |
author_facet | Chiles, Joe W. Vijaykumar, Kadambari Darby, Adrienne Goetz, Ryan L. Kane, Lauren E. Methukupally, Abhishek R. Gandotra, Sheetal Russell, Derek W. Whitson, Micah R. Kelmenson, Daniel |
author_sort | Chiles, Joe W. |
collection | PubMed |
description | PURPOSE: Acute lung injury associated with COVID-19 contributes significantly to its morbidity and mortality. Though invasive mechanical ventilation is sometimes necessary, the use of high flow nasal oxygen may avoid the need for mechanical ventilation in some patients. For patients approaching the limits of high flow nasal oxygen support, addition of inhaled pulmonary vasodilators is becoming more common but little is known about its effects. This is the first descriptive study of a cohort of patients receiving inhaled epoprostenol with high flow nasal oxygen for COVID-19. MATERIALS AND METHODS: We collected clinical data from the first fifty patients to receive inhaled epoprostenol while on high flow nasal oxygen at our institution. We compared the characteristics of patients who did and did not respond to epoprostenol addition. RESULTS: The 18 patients that did not stabilize or improve following initiation of inhaled epoprostenol had similar rates of invasive mechanical ventilation as those who improved or stabilized (50% vs 56%). Rates of mortality were not significantly different between the two groups (17% and 31%). CONCLUSIONS: In patients with COVID-19 induced hypoxemic respiratory failure, the use of inhaled epoprostenol with high flow nasal oxygen is feasible, but physiologic signs of response were not related to clinical outcomes. |
format | Online Article Text |
id | pubmed-8863404 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-88634042022-02-23 Letter to the Editor: “Use of inhaled epoprostenol with high flow nasal oxygen in non-intubated patients with severe COVID-19” Chiles, Joe W. Vijaykumar, Kadambari Darby, Adrienne Goetz, Ryan L. Kane, Lauren E. Methukupally, Abhishek R. Gandotra, Sheetal Russell, Derek W. Whitson, Micah R. Kelmenson, Daniel J Crit Care Article PURPOSE: Acute lung injury associated with COVID-19 contributes significantly to its morbidity and mortality. Though invasive mechanical ventilation is sometimes necessary, the use of high flow nasal oxygen may avoid the need for mechanical ventilation in some patients. For patients approaching the limits of high flow nasal oxygen support, addition of inhaled pulmonary vasodilators is becoming more common but little is known about its effects. This is the first descriptive study of a cohort of patients receiving inhaled epoprostenol with high flow nasal oxygen for COVID-19. MATERIALS AND METHODS: We collected clinical data from the first fifty patients to receive inhaled epoprostenol while on high flow nasal oxygen at our institution. We compared the characteristics of patients who did and did not respond to epoprostenol addition. RESULTS: The 18 patients that did not stabilize or improve following initiation of inhaled epoprostenol had similar rates of invasive mechanical ventilation as those who improved or stabilized (50% vs 56%). Rates of mortality were not significantly different between the two groups (17% and 31%). CONCLUSIONS: In patients with COVID-19 induced hypoxemic respiratory failure, the use of inhaled epoprostenol with high flow nasal oxygen is feasible, but physiologic signs of response were not related to clinical outcomes. Elsevier Inc. 2022-06 2022-02-23 /pmc/articles/PMC8863404/ /pubmed/35217371 http://dx.doi.org/10.1016/j.jcrc.2022.153989 Text en © 2022 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 | Article Chiles, Joe W. Vijaykumar, Kadambari Darby, Adrienne Goetz, Ryan L. Kane, Lauren E. Methukupally, Abhishek R. Gandotra, Sheetal Russell, Derek W. Whitson, Micah R. Kelmenson, Daniel Letter to the Editor: “Use of inhaled epoprostenol with high flow nasal oxygen in non-intubated patients with severe COVID-19” |
title | Letter to the Editor: “Use of inhaled epoprostenol with high flow nasal oxygen in non-intubated patients with severe COVID-19” |
title_full | Letter to the Editor: “Use of inhaled epoprostenol with high flow nasal oxygen in non-intubated patients with severe COVID-19” |
title_fullStr | Letter to the Editor: “Use of inhaled epoprostenol with high flow nasal oxygen in non-intubated patients with severe COVID-19” |
title_full_unstemmed | Letter to the Editor: “Use of inhaled epoprostenol with high flow nasal oxygen in non-intubated patients with severe COVID-19” |
title_short | Letter to the Editor: “Use of inhaled epoprostenol with high flow nasal oxygen in non-intubated patients with severe COVID-19” |
title_sort | letter to the editor: “use of inhaled epoprostenol with high flow nasal oxygen in non-intubated patients with severe covid-19” |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8863404/ https://www.ncbi.nlm.nih.gov/pubmed/35217371 http://dx.doi.org/10.1016/j.jcrc.2022.153989 |
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