Efficacy and Safety of High PEEP NIV in COVID-19 Patients

To investigate the efficacy and safety of non-invasive ventilation (NIV) with high PEEP levels application in patients with COVID-19-related acute respiratory distress syndrome (ARDS). This is a retrospective cohort study with data collected from 95 patients who were administered NIV as part of thei...

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Published in:Disaster medicine and public health preparedness 2024-05, Vol.18, p.e97-e97, Article e97
Main Authors: Šitum, Ivan, Hrvoić, Lovro, Mamić, Gloria, Džaja, Nikolina, Popović, Zvonimir, Karković, Nikica, Jurković, Ivan, Erceg, Ante, Premužić, Vedran, Mažar, Mirabel, Mihaljević, Slobodan, Perković, Romana, Karmelić, Dora, Lovrić, Daniel
Format: Article
Language:English
Subjects:
Adult
Aged
Cohort analysis
Cohort Studies
Comorbidity
Continuous positive airway pressure
Coronaviruses
COVID-19
COVID-19 - complications
COVID-19 - therapy
Croatia
Female
Hospitals
Humans
Intensive care
Intensive Care Units
Intubation
Male
Middle Aged
Mortality
Noninvasive Ventilation - methods
Original Research
Patients
Pneumonia
Positive-Pressure Respiration - methods
Respiratory Distress Syndrome - therapy
Respiratory failure
Retrospective Studies
SARS-CoV-2
Treatment Outcome
Ventilators
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Summary:To investigate the efficacy and safety of non-invasive ventilation (NIV) with high PEEP levels application in patients with COVID-19-related acute respiratory distress syndrome (ARDS). This is a retrospective cohort study with data collected from 95 patients who were administered NIV as part of their treatment in the COVID-19 intensive care unit (ICU) at University Hospital Centre Zagreb between October 2021 and February 2022. The definite outcome was NIV failure. High PEEP NIV was applied in all 95 patients; 54 (56.84%) patients could be kept solely on NIV, while 41 (43.16%) patients required intubation. ICU mortality of patients solely on NIV was 3.70%, while total ICU mortality was 35.79%. The most significant difference in the dynamic of respiratory parameters between 2 patient groups was visible on Day 3 of ICU stay: By that day, patients kept solely on NIV required significantly lower PEEP levels and had better improvement in PaO , P/F ratio, and HACOR score. High PEEP applied by NIV was a safe option for the initial respiratory treatment of all patients, despite the severity of ARDS. For some patients, it was also shown to be the only necessary form of oxygen supplementation.
ISSN:1935-7893
1938-744X
DOI:10.1017/dmp.2024.85