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A Retrospective Analysis of Ventilatory Strategy Comparing Non-invasive Ventilation (NIV) With Invasive Ventilation in Patients Admitted With Severe COVID-19 Pneumonia
Background The second wave of the COVID-19 pandemic in India saw a sudden upsurge of critically ill patients getting admitted to the ICU. The guidance for respiratory support was unclear in the early phase. But later reports showed lower mortality with non-invasive ventilation (NIV) than with intuba...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968367/ https://www.ncbi.nlm.nih.gov/pubmed/36855494 http://dx.doi.org/10.7759/cureus.34249 |
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author | Srinivasaiah, Madhu Krishnappa Gowda Varma, Manu M M G, Nandini V, Chaitra Gulur, Harshitha V, Harshitha |
author_facet | Srinivasaiah, Madhu Krishnappa Gowda Varma, Manu M M G, Nandini V, Chaitra Gulur, Harshitha V, Harshitha |
author_sort | Srinivasaiah, Madhu |
collection | PubMed |
description | Background The second wave of the COVID-19 pandemic in India saw a sudden upsurge of critically ill patients getting admitted to the ICU. The guidance for respiratory support was unclear in the early phase. But later reports showed lower mortality with non-invasive ventilation (NIV) than with intubation. The aim of this study was to assess the end result of initial methods of ventilation in COVID-19 patients. Methodology Patients admitted to ICU with COVID-19 were categorized as group 1 (IPPV-intubated within 24 hrs of admission), group 2 (NIV -NIV only), group 3 (NIV+ IPPV-intubated after 24 hrs), and group 4 (NRBM - Non-Rebreathing Mask only). All causes in the hospital or 30-day mortality, length of stay in ICU, and incidence of pneumothorax were compared between groups. Logistic regression analysis was done to determine the odds of mortality. Results The overall mortality rate among patients admitted to tertiary care centers was 15% and the rate among patients in ICU was 54.07%. Patients in group 1 and group 3 had significantly high mortality rates of 90.47% and 93.75%, respectively, as compared to 51.28% in group 2 patients. The odds of mortality were high in group 3 (OR 29.57, 95% CI 4.51 and 193.52) and group 1 (OR 8.01, 95% CI 1.35 and 47.48). Conclusion In a resource-limited setting, the use of NIV is associated with higher survival in COVID-19 patients. The prognosis of patients who are intubated early or after a trial of NIV is the same with increased odds of mortality. |
format | Online Article Text |
id | pubmed-9968367 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-99683672023-02-27 A Retrospective Analysis of Ventilatory Strategy Comparing Non-invasive Ventilation (NIV) With Invasive Ventilation in Patients Admitted With Severe COVID-19 Pneumonia Srinivasaiah, Madhu Krishnappa Gowda Varma, Manu M M G, Nandini V, Chaitra Gulur, Harshitha V, Harshitha Cureus Anesthesiology Background The second wave of the COVID-19 pandemic in India saw a sudden upsurge of critically ill patients getting admitted to the ICU. The guidance for respiratory support was unclear in the early phase. But later reports showed lower mortality with non-invasive ventilation (NIV) than with intubation. The aim of this study was to assess the end result of initial methods of ventilation in COVID-19 patients. Methodology Patients admitted to ICU with COVID-19 were categorized as group 1 (IPPV-intubated within 24 hrs of admission), group 2 (NIV -NIV only), group 3 (NIV+ IPPV-intubated after 24 hrs), and group 4 (NRBM - Non-Rebreathing Mask only). All causes in the hospital or 30-day mortality, length of stay in ICU, and incidence of pneumothorax were compared between groups. Logistic regression analysis was done to determine the odds of mortality. Results The overall mortality rate among patients admitted to tertiary care centers was 15% and the rate among patients in ICU was 54.07%. Patients in group 1 and group 3 had significantly high mortality rates of 90.47% and 93.75%, respectively, as compared to 51.28% in group 2 patients. The odds of mortality were high in group 3 (OR 29.57, 95% CI 4.51 and 193.52) and group 1 (OR 8.01, 95% CI 1.35 and 47.48). Conclusion In a resource-limited setting, the use of NIV is associated with higher survival in COVID-19 patients. The prognosis of patients who are intubated early or after a trial of NIV is the same with increased odds of mortality. Cureus 2023-01-26 /pmc/articles/PMC9968367/ /pubmed/36855494 http://dx.doi.org/10.7759/cureus.34249 Text en Copyright © 2023, Srinivasaiah et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Anesthesiology Srinivasaiah, Madhu Krishnappa Gowda Varma, Manu M M G, Nandini V, Chaitra Gulur, Harshitha V, Harshitha A Retrospective Analysis of Ventilatory Strategy Comparing Non-invasive Ventilation (NIV) With Invasive Ventilation in Patients Admitted With Severe COVID-19 Pneumonia |
title | A Retrospective Analysis of Ventilatory Strategy Comparing Non-invasive Ventilation (NIV) With Invasive Ventilation in Patients Admitted With Severe COVID-19 Pneumonia |
title_full | A Retrospective Analysis of Ventilatory Strategy Comparing Non-invasive Ventilation (NIV) With Invasive Ventilation in Patients Admitted With Severe COVID-19 Pneumonia |
title_fullStr | A Retrospective Analysis of Ventilatory Strategy Comparing Non-invasive Ventilation (NIV) With Invasive Ventilation in Patients Admitted With Severe COVID-19 Pneumonia |
title_full_unstemmed | A Retrospective Analysis of Ventilatory Strategy Comparing Non-invasive Ventilation (NIV) With Invasive Ventilation in Patients Admitted With Severe COVID-19 Pneumonia |
title_short | A Retrospective Analysis of Ventilatory Strategy Comparing Non-invasive Ventilation (NIV) With Invasive Ventilation in Patients Admitted With Severe COVID-19 Pneumonia |
title_sort | retrospective analysis of ventilatory strategy comparing non-invasive ventilation (niv) with invasive ventilation in patients admitted with severe covid-19 pneumonia |
topic | Anesthesiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968367/ https://www.ncbi.nlm.nih.gov/pubmed/36855494 http://dx.doi.org/10.7759/cureus.34249 |
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