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Timing to Intubation COVID-19 Patients: Can We Put It Off until Tomorrow?
Background: The decision to intubate COVID-19 patients receiving non-invasive respiratory support is challenging, requiring a fine balance between early intubation and risks of invasive mechanical ventilation versus the adverse effects of delaying intubation. This present study analyzes the associat...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871804/ https://www.ncbi.nlm.nih.gov/pubmed/35206821 http://dx.doi.org/10.3390/healthcare10020206 |
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author | de Alencar, Júlio César Garcia Sternlicht, Juliana Martes Veiga, Alicia Dudy Muller Marchini, Julio Flávio Meirelles Ferreira, Juliana Carvalho de Carvalho, Carlos Roberto Ribeiro Marcilio, Izabel da Silva, Katia Regina Cobello Junior, Vilson Felix, Marcelo Consorti Gomez, Luz Marina Gomez de Souza, Heraldo Possolo Mauá, Denis Deratani Emergency USP COVID Group, HCFMUSP COVID-19 Study Group, |
author_facet | de Alencar, Júlio César Garcia Sternlicht, Juliana Martes Veiga, Alicia Dudy Muller Marchini, Julio Flávio Meirelles Ferreira, Juliana Carvalho de Carvalho, Carlos Roberto Ribeiro Marcilio, Izabel da Silva, Katia Regina Cobello Junior, Vilson Felix, Marcelo Consorti Gomez, Luz Marina Gomez de Souza, Heraldo Possolo Mauá, Denis Deratani Emergency USP COVID Group, HCFMUSP COVID-19 Study Group, |
author_sort | de Alencar, Júlio César Garcia |
collection | PubMed |
description | Background: The decision to intubate COVID-19 patients receiving non-invasive respiratory support is challenging, requiring a fine balance between early intubation and risks of invasive mechanical ventilation versus the adverse effects of delaying intubation. This present study analyzes the association between intubation day and mortality in COVID-19 patients. Methods: We performed a unicentric retrospective cohort study considering all COVID-19 patients consecutively admitted between March 2020 and August 2020 requiring invasive mechanical ventilation. The primary outcome was all-cause mortality within 28 days after intubation, and a Cox model was used to evaluate the effect of time from onset of symptoms to intubation in mortality. Results: A total of 592 (20%) patients of 3020 admitted with COVID-19 were intubated during study period, and 310 patients who were intubated deceased 28 days after intubation. Each additional day between the onset of symptoms and intubation was significantly associated with higher in-hospital death (adjusted hazard ratio, 1.018; 95% CI, 1.005–1.03). Conclusion: Among patients infected with SARS-CoV-2 who were intubated and mechanically ventilated, delaying intubation in the course of symptoms may be associated with higher mortality. Trial registration: The study protocol was approved by the local Ethics Committee (opinion number 3.990.817; CAAE: 30417520.0.0000.0068). |
format | Online Article Text |
id | pubmed-8871804 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-88718042022-02-25 Timing to Intubation COVID-19 Patients: Can We Put It Off until Tomorrow? de Alencar, Júlio César Garcia Sternlicht, Juliana Martes Veiga, Alicia Dudy Muller Marchini, Julio Flávio Meirelles Ferreira, Juliana Carvalho de Carvalho, Carlos Roberto Ribeiro Marcilio, Izabel da Silva, Katia Regina Cobello Junior, Vilson Felix, Marcelo Consorti Gomez, Luz Marina Gomez de Souza, Heraldo Possolo Mauá, Denis Deratani Emergency USP COVID Group, HCFMUSP COVID-19 Study Group, Healthcare (Basel) Article Background: The decision to intubate COVID-19 patients receiving non-invasive respiratory support is challenging, requiring a fine balance between early intubation and risks of invasive mechanical ventilation versus the adverse effects of delaying intubation. This present study analyzes the association between intubation day and mortality in COVID-19 patients. Methods: We performed a unicentric retrospective cohort study considering all COVID-19 patients consecutively admitted between March 2020 and August 2020 requiring invasive mechanical ventilation. The primary outcome was all-cause mortality within 28 days after intubation, and a Cox model was used to evaluate the effect of time from onset of symptoms to intubation in mortality. Results: A total of 592 (20%) patients of 3020 admitted with COVID-19 were intubated during study period, and 310 patients who were intubated deceased 28 days after intubation. Each additional day between the onset of symptoms and intubation was significantly associated with higher in-hospital death (adjusted hazard ratio, 1.018; 95% CI, 1.005–1.03). Conclusion: Among patients infected with SARS-CoV-2 who were intubated and mechanically ventilated, delaying intubation in the course of symptoms may be associated with higher mortality. Trial registration: The study protocol was approved by the local Ethics Committee (opinion number 3.990.817; CAAE: 30417520.0.0000.0068). MDPI 2022-01-21 /pmc/articles/PMC8871804/ /pubmed/35206821 http://dx.doi.org/10.3390/healthcare10020206 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article de Alencar, Júlio César Garcia Sternlicht, Juliana Martes Veiga, Alicia Dudy Muller Marchini, Julio Flávio Meirelles Ferreira, Juliana Carvalho de Carvalho, Carlos Roberto Ribeiro Marcilio, Izabel da Silva, Katia Regina Cobello Junior, Vilson Felix, Marcelo Consorti Gomez, Luz Marina Gomez de Souza, Heraldo Possolo Mauá, Denis Deratani Emergency USP COVID Group, HCFMUSP COVID-19 Study Group, Timing to Intubation COVID-19 Patients: Can We Put It Off until Tomorrow? |
title | Timing to Intubation COVID-19 Patients: Can We Put It Off until Tomorrow? |
title_full | Timing to Intubation COVID-19 Patients: Can We Put It Off until Tomorrow? |
title_fullStr | Timing to Intubation COVID-19 Patients: Can We Put It Off until Tomorrow? |
title_full_unstemmed | Timing to Intubation COVID-19 Patients: Can We Put It Off until Tomorrow? |
title_short | Timing to Intubation COVID-19 Patients: Can We Put It Off until Tomorrow? |
title_sort | timing to intubation covid-19 patients: can we put it off until tomorrow? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871804/ https://www.ncbi.nlm.nih.gov/pubmed/35206821 http://dx.doi.org/10.3390/healthcare10020206 |
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