Timing to Intubation COVID-19 Patients: Can We Put It Off until Tomorrow?

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Citações na Scopus
2
Tipo de produção
article
Data de publicação
2022
Título da Revista
ISSN da Revista
Título do Volume
Editora
MDPI
Citação
HEALTHCARE, v.10, n.2, article ID 206, 10p, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: The decision to intubate COVID-19 patients receiving non-invasive respiratory support is challenging, requiring a fine balance between early intubation and risks of invasive mechanical ventilation versus the adverse effects of delaying intubation. This present study analyzes the association between intubation day and mortality in COVID-19 patients. Methods: We performed a unicentric retrospective cohort study considering all COVID-19 patients consecutively admitted between March 2020 and August 2020 requiring invasive mechanical ventilation. The primary outcome was all-cause mortality within 28 days after intubation, and a Cox model was used to evaluate the effect of time from onset of symptoms to intubation in mortality. Results: A total of 592 (20%) patients of 3020 admitted with COVID-19 were intubated during study period, and 310 patients who were intubated deceased 28 days after intubation. Each additional day between the onset of symptoms and intubation was significantly associated with higher in-hospital death (adjusted hazard ratio, 1.018; 95% CI, 1.005-1.03). Conclusion: Among patients infected with SARS-CoV-2 who were intubated and mechanically ventilated, delaying intubation in the course of symptoms may be associated with higher mortality. Trial registration: The study protocol was approved by the local Ethics Committee (opinion number 3.990.817; CAAE: 30417520.0.0000.0068).
Palavras-chave
SARS-CoV-2, COVID-19, intubation, emergency medicine
Referências
  1. [Anonymous], 2021, WORLD HLTH ORGWNIZAT
  2. April MD, 2021, RESUSCITATION, V162, P403, DOI 10.1016/j.resuscitation.2021.02.039
  3. Bauer PR, 2017, MAYO CLIN PROC, V92, P1502, DOI 10.1016/j.mayocp.2017.07.001
  4. Berlin DA, 2020, NEW ENGL J MED, V383, P2451, DOI 10.1056/NEJMcp2009575
  5. Brown Calvin A 3rd, 2020, J Am Coll Emerg Physicians Open, DOI 10.1002/emp2.12063
  6. Cook TM, 2020, ANAESTHESIA, V75, P785, DOI 10.1111/anae.15054
  7. De Jong A, 2018, CRIT CARE MED, V46, P532, DOI 10.1097/CCM.0000000000002925
  8. Fan E, 2018, JAMA-J AM MED ASSOC, V319, P698, DOI 10.1001/jama.2017.21907
  9. Fayed M, 2021, CUREUS, V13, DOI 10.7759/cureus.19620
  10. Ferreira JC, 2021, ANN INTENSIVE CARE, V11, DOI 10.1186/s13613-021-00882-w
  11. de Alencar JCG, 2020, JACEP OPEN, V1, P699, DOI 10.1002/emp2.12219
  12. Heffner AC, 2013, RESUSCITATION, V84, P1500, DOI 10.1016/j.resuscitation.2013.07.022
  13. Kangelaris KN, 2016, CRIT CARE MED, V44, P120, DOI 10.1097/CCM.0000000000001359
  14. Knight SR, 2020, BMJ-BRIT MED J, V370, DOI 10.1136/bmj.m3339
  15. Marini JJ, 2020, JAMA-J AM MED ASSOC, V323, P2329, DOI 10.1001/jama.2020.6825
  16. Mohammadi Mostafa, 2021, Anesth Pain Med, V11, pe115868, DOI 10.5812/aapm.115868
  17. Neto FL, 2021, CLIN MICROBIOL INFEC, V27, DOI 10.1016/j.cmi.2021.03.002
  18. Papoutsi E, 2021, CRIT CARE, V25, DOI 10.1186/s13054-021-03540-6
  19. Pham T, 2017, MAYO CLIN PROC, V92, P1382, DOI 10.1016/j.mayocp.2017.05.004
  20. Pun BT, 2021, LANCET RESP MED, V9, P239, DOI 10.1016/S2213-2600(20)30552-X
  21. Ranieri VM, 2012, JAMA-J AM MED ASSOC, V307, P2526, DOI 10.1001/jama.2012.5669
  22. Ranzani OT, 2021, LANCET RESP MED, V9, P407, DOI 10.1016/S2213-2600(20)30560-9
  23. Roedl K, 2021, AUST CRIT CARE, V34, P167, DOI 10.1016/j.aucc.2020.10.009
  24. Schmidt M, 2020, LANCET RESP MED, V8, P1121, DOI 10.1016/S2213-2600(20)30328-3
  25. Tobin MJ, 2020, ANN INTENSIVE CARE, V10, DOI 10.1186/s13613-020-00692-6
  26. TOBIN MJ, 1994, NEW ENGL J MED, V330, P1056, DOI 10.1056/NEJM199404143301507