Volume 81, Issue 8 (November 2023)
Tehran Univ Med J 2023, 81(8): 581-587 |
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Farnoosh N, Seyfi S, Ezoji K, Shakeri A, Latifi K, Amri Male P. Evaluating the efficacy of noninvasive ventilation (NIV) in the treatment of acute respiratory failure (an experience from the Covid-19 pandemic). Tehran Univ Med J 2023; 81 (8) :581-587
URL: http://tumj.tums.ac.ir/article-1-12743-en.html
URL: http://tumj.tums.ac.ir/article-1-12743-en.html
Nazli Farnoosh1 
, Shahram Seyfi2 , Khadijeh Ezoji3 , Asadollah Shakeri4 , Kayvan Latifi5 , Parviz Amri Male * 2
, Shahram Seyfi2 , Khadijeh Ezoji3 , Asadollah Shakeri4 , Kayvan Latifi5 , Parviz Amri Male * 2
1- Department of Anesthesiology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
2- Department of Anesthesiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
3- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babal, Iran.
4- Department of Anesthesiology, Ali IbneAbitaleb Hospital, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
5- Department of Anesthesiology, Operating Room and Emergencies, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.
2- Department of Anesthesiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
3- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babal, Iran.
4- Department of Anesthesiology, Ali IbneAbitaleb Hospital, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
5- Department of Anesthesiology, Operating Room and Emergencies, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.
Abstract: (448 Views)
Background: Noninvasive ventilation (NIV) has been used as one of the most promising methods to treat hypoxic respiratory failure in COVID-19.
Methods: In this study, the clinical outcomes of 80 patients with acute respiratory failure caused by COVID-19 were evaluated. The disease was confirmed in two methods: clinical and radiographic confirmation of disease in patients with an acute respiratory infection (highly suspected) or in some cases with a positive PCR test. The rate of discharge from the ICU without the need for intubation was evaluated as the primary outcome and based on that, the patients were divided into two groups: NIV failure and NIV success. Mortality rate, length of stay in ICU, frequency of intubated patients and laboratory factors of patients as secondary outcomes in two groups were compared.
Results: Regarding the outcome of death and discharge, there was a statistically significant difference between the two groups. Therefore, all patients with corona who were admitted to ICU and received NIV and were intubated due to non-responsiveness to NIV died and the patients were discharged from the hospital without intubation. All the patients investigated in this study, had received antiviral, antibiotic, and glucocorticoid treatment during hospitalization. In this study, the patients who were in the NIV success group and were not intubated had a lower mean age compared to the group without NIV success (54 vs. 67 years, respectively). The number of white blood cells in the NIV success group was 3945.28±10011.21 and in the group without NIV success was 9242.38±17296.16, which was statistically significant (P=0.004). The number of blood neutrophils in the successful and unsuccessful NIV groups was 12.19±83.04 and 4.31±89.49, respectively (P=0.034). The mean APACHEII score in patients in the NIV success group (11.07±5.05) was significantly lower than the group without NIV success (20.16±4.96).
Methods: In this study, the clinical outcomes of 80 patients with acute respiratory failure caused by COVID-19 were evaluated. The disease was confirmed in two methods: clinical and radiographic confirmation of disease in patients with an acute respiratory infection (highly suspected) or in some cases with a positive PCR test. The rate of discharge from the ICU without the need for intubation was evaluated as the primary outcome and based on that, the patients were divided into two groups: NIV failure and NIV success. Mortality rate, length of stay in ICU, frequency of intubated patients and laboratory factors of patients as secondary outcomes in two groups were compared.
Results: Regarding the outcome of death and discharge, there was a statistically significant difference between the two groups. Therefore, all patients with corona who were admitted to ICU and received NIV and were intubated due to non-responsiveness to NIV died and the patients were discharged from the hospital without intubation. All the patients investigated in this study, had received antiviral, antibiotic, and glucocorticoid treatment during hospitalization. In this study, the patients who were in the NIV success group and were not intubated had a lower mean age compared to the group without NIV success (54 vs. 67 years, respectively). The number of white blood cells in the NIV success group was 3945.28±10011.21 and in the group without NIV success was 9242.38±17296.16, which was statistically significant (P=0.004). The number of blood neutrophils in the successful and unsuccessful NIV groups was 12.19±83.04 and 4.31±89.49, respectively (P=0.034). The mean APACHEII score in patients in the NIV success group (11.07±5.05) was significantly lower than the group without NIV success (20.16±4.96).
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Conclusion: Mortality was higher in the intubated group than in the NIV group. The combination of APACHEII score and respiratory rate one hour after receiving NIV can predict success with NIV.
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Type of Study: Original Article |
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