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Acute Improvements of Oxygenation with Cpap and Clinical Outcomes in Severe COVID-19 Pneumonia: A Multicenter, Retrospective Study

It is not known if the degrees of improvement in oxygenation obtained by CPAP can predict clinical outcomes in patients with COVID-19 pneumonia. This was a retrospective study conducted on patients with severe COVID-19 pneumonia treated with CPAP in three University hospitals in Milan, Italy, from M...

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Autores principales: Pini, Stefano, Radovanovic, Dejan, Saad, Marina, Gatti, Marina, Danzo, Fiammetta, Mondoni, Michele, Aliberti, Stefano, Centanni, Stefano, Blasi, Francesco, Chiumello, Davide Alberto, Santus, Pierachille
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735603/
https://www.ncbi.nlm.nih.gov/pubmed/36498759
http://dx.doi.org/10.3390/jcm11237186
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author Pini, Stefano
Radovanovic, Dejan
Saad, Marina
Gatti, Marina
Danzo, Fiammetta
Mondoni, Michele
Aliberti, Stefano
Centanni, Stefano
Blasi, Francesco
Chiumello, Davide Alberto
Santus, Pierachille
author_facet Pini, Stefano
Radovanovic, Dejan
Saad, Marina
Gatti, Marina
Danzo, Fiammetta
Mondoni, Michele
Aliberti, Stefano
Centanni, Stefano
Blasi, Francesco
Chiumello, Davide Alberto
Santus, Pierachille
author_sort Pini, Stefano
collection PubMed
description It is not known if the degrees of improvement in oxygenation obtained by CPAP can predict clinical outcomes in patients with COVID-19 pneumonia. This was a retrospective study conducted on patients with severe COVID-19 pneumonia treated with CPAP in three University hospitals in Milan, Italy, from March 2020 to March 2021. Arterial gas analysis was obtained before and 1 h after starting CPAP. CPAP failure included either death in the respiratory units while on CPAP or the need for intubation. Two hundred and eleven patients (mean age 64 years, 74% males) were included. Baseline median PaO(2), PaO(2)/FiO(2) ratio (P/F), and the alveolar-arterial (A-a) O(2) gradient were 68 (57–83) mmHg, 129 (91–179) mmHg and 310 (177–559) mmHg, respectively. Forty-two (19.9%) patients died in the respiratory units and 51 (24.2%) were intubated. After starting CPAP, PaO(2)/FiO(2) increased by 57 (12–113; p < 0.001) mmHg, and (A-a) O(2) was reduced by 68 (−25–250; p < 0.001) mmHg. A substantial overlap of PaO(2), P/F, and A-a gradient at baseline and during CPAP was observed in CPAP failures and successes; CPAP-associated improvements in oxygenation in both groups were similar. In conclusion, CPAP-associated improvements in oxygenation do not predict clinical outcomes in patients with severe COVID-19 pneumonia.
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spelling pubmed-97356032022-12-11 Acute Improvements of Oxygenation with Cpap and Clinical Outcomes in Severe COVID-19 Pneumonia: A Multicenter, Retrospective Study Pini, Stefano Radovanovic, Dejan Saad, Marina Gatti, Marina Danzo, Fiammetta Mondoni, Michele Aliberti, Stefano Centanni, Stefano Blasi, Francesco Chiumello, Davide Alberto Santus, Pierachille J Clin Med Article It is not known if the degrees of improvement in oxygenation obtained by CPAP can predict clinical outcomes in patients with COVID-19 pneumonia. This was a retrospective study conducted on patients with severe COVID-19 pneumonia treated with CPAP in three University hospitals in Milan, Italy, from March 2020 to March 2021. Arterial gas analysis was obtained before and 1 h after starting CPAP. CPAP failure included either death in the respiratory units while on CPAP or the need for intubation. Two hundred and eleven patients (mean age 64 years, 74% males) were included. Baseline median PaO(2), PaO(2)/FiO(2) ratio (P/F), and the alveolar-arterial (A-a) O(2) gradient were 68 (57–83) mmHg, 129 (91–179) mmHg and 310 (177–559) mmHg, respectively. Forty-two (19.9%) patients died in the respiratory units and 51 (24.2%) were intubated. After starting CPAP, PaO(2)/FiO(2) increased by 57 (12–113; p < 0.001) mmHg, and (A-a) O(2) was reduced by 68 (−25–250; p < 0.001) mmHg. A substantial overlap of PaO(2), P/F, and A-a gradient at baseline and during CPAP was observed in CPAP failures and successes; CPAP-associated improvements in oxygenation in both groups were similar. In conclusion, CPAP-associated improvements in oxygenation do not predict clinical outcomes in patients with severe COVID-19 pneumonia. MDPI 2022-12-02 /pmc/articles/PMC9735603/ /pubmed/36498759 http://dx.doi.org/10.3390/jcm11237186 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
Pini, Stefano
Radovanovic, Dejan
Saad, Marina
Gatti, Marina
Danzo, Fiammetta
Mondoni, Michele
Aliberti, Stefano
Centanni, Stefano
Blasi, Francesco
Chiumello, Davide Alberto
Santus, Pierachille
Acute Improvements of Oxygenation with Cpap and Clinical Outcomes in Severe COVID-19 Pneumonia: A Multicenter, Retrospective Study
title Acute Improvements of Oxygenation with Cpap and Clinical Outcomes in Severe COVID-19 Pneumonia: A Multicenter, Retrospective Study
title_full Acute Improvements of Oxygenation with Cpap and Clinical Outcomes in Severe COVID-19 Pneumonia: A Multicenter, Retrospective Study
title_fullStr Acute Improvements of Oxygenation with Cpap and Clinical Outcomes in Severe COVID-19 Pneumonia: A Multicenter, Retrospective Study
title_full_unstemmed Acute Improvements of Oxygenation with Cpap and Clinical Outcomes in Severe COVID-19 Pneumonia: A Multicenter, Retrospective Study
title_short Acute Improvements of Oxygenation with Cpap and Clinical Outcomes in Severe COVID-19 Pneumonia: A Multicenter, Retrospective Study
title_sort acute improvements of oxygenation with cpap and clinical outcomes in severe covid-19 pneumonia: a multicenter, retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735603/
https://www.ncbi.nlm.nih.gov/pubmed/36498759
http://dx.doi.org/10.3390/jcm11237186
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