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Role of chest radiograph in predicting the need for ventilator support in COVID-19 patients

BACKGROUND: COVID-19 disease, a pandemic for more than two years, has major morbidity and mortality related to pulmonary involvement. Chest radiography is the main imaging tool for critically ill patients. As the availability of arterial blood gas analysis is limited in the Level I and II healthcare...

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Autores principales: Patnayak, G, Rastogi, R, Khajuria, L, Mohan, A, Jain, N, Varshney, R, Singh, V K, Pratap, V, Pathak, S, Jain, A, Duggad, K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: South African Medical Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9923502/
https://www.ncbi.nlm.nih.gov/pubmed/36798522
http://dx.doi.org/10.7196/AJTCCM.2022.v28i4.248
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author Patnayak, G
Rastogi, R
Khajuria, L
Mohan, A
Jain, N
Varshney, R
Singh, V K
Pratap, V
Pathak, S
Jain, A
Duggad, K
author_facet Patnayak, G
Rastogi, R
Khajuria, L
Mohan, A
Jain, N
Varshney, R
Singh, V K
Pratap, V
Pathak, S
Jain, A
Duggad, K
author_sort Patnayak, G
collection PubMed
description BACKGROUND: COVID-19 disease, a pandemic for more than two years, has major morbidity and mortality related to pulmonary involvement. Chest radiography is the main imaging tool for critically ill patients. As the availability of arterial blood gas analysis is limited in the Level I and II healthcare centres, which are major partners in providing healthcare in resource-limited times, we planned the present study. OBJECTIVES: To assess the role of chest radiography in predicting the need for oxygen/ventilator support in critically ill COVID-19 patients. METHODS: This hospital-based, retrospective study included 135 patients who needed oxygen/ventilator support and had optimal-quality chest radiographs at admission. All the chest X-rays were evaluated and a severity score was calculated on a predesigned pro forma. Statistical evaluation of the data obtained was done using appropriate tools and methods. RESULTS: Males outnumbered females, with a mean age of 54.35 ± 14.49 years. More than 72% of patients included in our study needed ventilator support while the rest needed oxygen support. There was a significant statistical correlation between the chest radiograph severity score and SPO(2) /PaO(2) levels in our study. Using a cut-off value >8 for the chest radiograph severity score in predicting the need for ventilator support in a Covid-19 patient, the sensitivity, specificity and accuracy was 85.7%, 92.5% and 89.5%, respectively. CONCLUSION: Chest radiography remains the mainstay of imaging in critically ill COVID-19 patients when they are on multiple life-support systems. Though arterial blood gas analysis is the gold standard tool for assessing the need for oxygen/ventilator support in these patients, the severity score obtained from the initial chest radiograph at the time of admission may also be used as a screening tool. Chest radiography may predict the need for oxygen/ventilator support, allowing time for patients to be moved to an appropriate-level healthcare centre, thus limiting morbidity and mortality.
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spelling pubmed-99235022023-02-15 Role of chest radiograph in predicting the need for ventilator support in COVID-19 patients Patnayak, G Rastogi, R Khajuria, L Mohan, A Jain, N Varshney, R Singh, V K Pratap, V Pathak, S Jain, A Duggad, K Afr J Thorac Crit Care Med Research BACKGROUND: COVID-19 disease, a pandemic for more than two years, has major morbidity and mortality related to pulmonary involvement. Chest radiography is the main imaging tool for critically ill patients. As the availability of arterial blood gas analysis is limited in the Level I and II healthcare centres, which are major partners in providing healthcare in resource-limited times, we planned the present study. OBJECTIVES: To assess the role of chest radiography in predicting the need for oxygen/ventilator support in critically ill COVID-19 patients. METHODS: This hospital-based, retrospective study included 135 patients who needed oxygen/ventilator support and had optimal-quality chest radiographs at admission. All the chest X-rays were evaluated and a severity score was calculated on a predesigned pro forma. Statistical evaluation of the data obtained was done using appropriate tools and methods. RESULTS: Males outnumbered females, with a mean age of 54.35 ± 14.49 years. More than 72% of patients included in our study needed ventilator support while the rest needed oxygen support. There was a significant statistical correlation between the chest radiograph severity score and SPO(2) /PaO(2) levels in our study. Using a cut-off value >8 for the chest radiograph severity score in predicting the need for ventilator support in a Covid-19 patient, the sensitivity, specificity and accuracy was 85.7%, 92.5% and 89.5%, respectively. CONCLUSION: Chest radiography remains the mainstay of imaging in critically ill COVID-19 patients when they are on multiple life-support systems. Though arterial blood gas analysis is the gold standard tool for assessing the need for oxygen/ventilator support in these patients, the severity score obtained from the initial chest radiograph at the time of admission may also be used as a screening tool. Chest radiography may predict the need for oxygen/ventilator support, allowing time for patients to be moved to an appropriate-level healthcare centre, thus limiting morbidity and mortality. South African Medical Association 2022-12-19 /pmc/articles/PMC9923502/ /pubmed/36798522 http://dx.doi.org/10.7196/AJTCCM.2022.v28i4.248 Text en https://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution - NonCommercial Works License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Patnayak, G
Rastogi, R
Khajuria, L
Mohan, A
Jain, N
Varshney, R
Singh, V K
Pratap, V
Pathak, S
Jain, A
Duggad, K
Role of chest radiograph in predicting the need for ventilator support in COVID-19 patients
title Role of chest radiograph in predicting the need for ventilator support in COVID-19 patients
title_full Role of chest radiograph in predicting the need for ventilator support in COVID-19 patients
title_fullStr Role of chest radiograph in predicting the need for ventilator support in COVID-19 patients
title_full_unstemmed Role of chest radiograph in predicting the need for ventilator support in COVID-19 patients
title_short Role of chest radiograph in predicting the need for ventilator support in COVID-19 patients
title_sort role of chest radiograph in predicting the need for ventilator support in covid-19 patients
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9923502/
https://www.ncbi.nlm.nih.gov/pubmed/36798522
http://dx.doi.org/10.7196/AJTCCM.2022.v28i4.248
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