Noninvasive Ventilatory Support of Patients with COVID-19 outside the Intensive Care Units (WARd-COVID)

• Published in: Annals of the American Thoracic Society Vol. 18; no. 6; pp. 1020 - 1026
• Main Authors: Bellani, Giacomo, Grasselli, Giacomo, Cecconi, Maurizio, Antolini, Laura, Borelli, Massimo, De Giacomi, Federica, Bosio, Giancarlo, Latronico, Nicola, Filippini, Matteo, Gemma, Marco, Giannotti, Claudia, Antonini, Benvenuto, Petrucci, Nicola, Zerbi, Simone Maria, Maniglia, Paolo, Castelli, Gian Paolo, Marino, Giovanni, Subert, Matteo, Citerio, Giuseppe, Radrizzani, Danilo, Mediani, Teresa S., Lorini, Ferdinando Luca, Russo, Filippo Maria, Faletti, Angela, Beindorf, Andrea, Covello, Remo Daniel, Greco, Stefano, Bizzarri, Marta M., Ristagno, Giuseppe, Mojoli, Francesco, Pradella, Andrea, Severgnini, Paolo, Da Macallè, Marta, Albertin, Andrea, Ranieri, V. Marco, Rezoagli, Emanuele, Vitale, Giovanni, Magliocca, Aurora, Cappelleri, Gianluca, Docci, Mattia, Aliberti, Stefano, Serra, Filippo, Rossi, Emanuela, Valsecchi, Maria Grazia, Pesenti, Antonio, Foti, Giuseppe
• Format: Journal Article
• Language: English
• Published: New York American Thoracic Society 01.06.2021
• Subjects: Continuous positive airway pressure; COVID-19; Intensive care; Original Research; Studies
• ISSN: 2329-6933; 2325-6621
• DOI: 10.1513/AnnalsATS.202008-1080OC

(778/909; 85%) patients were treated with continuous positive airway pressure (CPAP), which was delivered by helmet in 617 (68%) patients. NIV failed in 300 patients (37.6%), whereas 498 (62.4%) patients were discharged alive without intubation. Overall mortality was 25%. NIV failure occurred in 152/284 (53%) patients with an arterial oxygen pressure (PaO2 )/fraction of inspired oxygen (FIO2 ) ratio ,150 mm Hg. Higher C-reactive protein and lower PaO2 /FIO2 and platelet counts were independently associated with increased risk of NIV failure. Conclusions: The use of NIV outside the ICUs was common in COVID-19, with a predominant use of helmet CPAP, with a rate of success .60% and close to 75% in full-treatment patients. C-reactive protein, PaO2 /FIO2 , and platelet counts were independently associated with increased risk of NIV failure.