Acute Respiratory Failure, Corona Virus Infection, Covid19
Conditions
Keywords
Noninvasive ventilation, High-flow nasal cannula, Severe Acute Respiratory Syndrome, Respiratory Failure, Respiratory Tract Diseases, Coronavirus Infection
Brief summary
COVID-19 pneumonia can cause severe acute hypoxemic respiratory failure. The usefulness of noninvasive respiratory support (NIRS), by means of nasal high-flow oxygen (NHFO), continuous positive airway pressure (CPAP), or noninvasive ventilation (NIV), established outside the intensive care unit, is unknown. The aim of this multicenter, retrospective, longitudinal study is to compare the effectiveness of these treatments to prevent death or endotracheal intubation at day 28, and what factors, related to the disease or to the characteristics of the treatment itself, can condition its success or failure.
Detailed description
Multicenter, retrospective, longitudinal study in consecutive adult COVID-19 patients with acute respiratory failure, requiring noninvasive respiratory support (NIRS) outside the intensive care unit (ICU) in 10 hospitals in Catalonia (Spain). Demographic, laboratory, clinical and noninvasive respiratory support data will be collected and analyzed according to the primary outcome (death or endotracheal intubation at day 28) and secondary outcomes (see the dedicated section). During the hospitalization, patients were treated according to the standard procedures of the participating centers. This study is observational and no randomization have been performed. Patients were followed up to either 28-days or hospital discharge if still hospitalized at day 28 from NIRS initiation.
Interventions
DEVICEHigh-flow nasal cannula treatment
Standard operating procedures represented by hihg-flow nasal cannula oxygen therapy
Standard operating procedures represented by continuous positive airway pressure (CPAP) therapy
DEVICENoninvasive ventilation treatment
Standard operating procedures represented by noninvasive ventilation treatment
Sponsors
Barcelona Institute for Global Health
Hospital Universitari Vall d'Hebron Research Institute
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* COVID-19 pneumonia confirmed with polymerase chain reaction (PCR). * Acute respiratory failure. * Treated by noninvasive respiratory support (nasal high-flow oxygen, CPAP or noninvasive ventilation), initiated outside the intensive care unit. * Age \> 18 years
Exclusion criteria
* Acute respiratory failure not related to COVID-19 * Hypercapnic acute respiratory failure * Early intolerance to treatment * Nosocomial infection * Pregnant woman
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Treatment failure | 28 days within noninvasive respiratory support initiation | Death or endotracheal intubation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 28-day mortality | 28 days within noninvasive respiratory support initiation | — |
| Hospital mortality | Until 28 days from noninvasive respiratory support initiation | Any death during hospital stay |
| Endotracheal intubation | 28 days within noninvasive respiratory support initiation | — |
| Duration of hospital stay | Until 28 days from noninvasive respiratory support initiation | Time between admission and discharge from hospital or death in hospital |
Countries
Spain
Outcome results
None listed