BACKGROUND: The efficacy and safety of continuous positive airway pressure and respiratory physiotherapy outside the Intensive Care Unit during a pandemic. METHODS: In this cohort study performed in February-May 2020 in a large teaching hospital in Milan, COVID-19 patients with adult respiratory distress syndrome receiving continuous positive airway pressure (positive end-expiratory pressure =10 cm H<inf>2</inf>O, FiO<inf>2</inf>=0.6, daily treatment duration: 4×3h-cycles) and respiratory physiotherapy including pronation outside the Intensive Care Unit were followed-up. RESULTS: Of 90 acute respiratory distress syndrome (ARDS) patients treated with continuous positive airway pressure (45/90, 50% pronated at least once) outside the Intensive Care Unit and with a median (interquartile) follow-up of 37 (11-46) days, 45 (50%) were discharged at home, 28 (31%) were still hospitalized, and 17 (19%) died. Continuous positive airway pressure failure was recorded for 35 (39%) patients. Patient mobilization was associated with reduced failure rates (P=0.033). No safety issues were observed. CONCLUSIONS: Continuous positive airway pressure with patient mobilization (including pronation) was effective and safe in patients with ARDS due to COVID-19 managed outside the Intensive Care Unit setting during the pandemic.
BACKGROUND: The efficacy and safety of continuous positive airway pressure and respiratory physiotherapy outside the Intensive Care Unit during a pandemic. METHODS: In this cohort study performed in February-May 2020 in a large teaching hospital in Milan, COVID-19 patients with adult respiratory distress syndrome receiving continuous positive airway pressure (positive end-expiratory pressure =10 cm H<inf>2</inf>O, FiO<inf>2</inf>=0.6, daily treatment duration: 4×3h-cycles) and respiratory physiotherapy including pronation outside the Intensive Care Unit were followed-up. RESULTS: Of 90 acute respiratory distress syndrome (ARDS) patients treated with continuous positive airway pressure (45/90, 50% pronated at least once) outside the Intensive Care Unit and with a median (interquartile) follow-up of 37 (11-46) days, 45 (50%) were discharged at home, 28 (31%) were still hospitalized, and 17 (19%) died. Continuous positive airway pressure failure was recorded for 35 (39%) patients. Patient mobilization was associated with reduced failure rates (P=0.033). No safety issues were observed. CONCLUSIONS: Continuous positive airway pressure with patient mobilization (including pronation) was effective and safe in patients with ARDS due to COVID-19 managed outside the Intensive Care Unit setting during the pandemic.
Authors: Giacomo Monti; Carlo Leggieri; Evgeny Fominskiy; Anna Mara Scandroglio; Sergio Colombo; Margherita Tozzi; Elena Moizo; Milena Mucci; Martina Crivellari; Marina Pieri; Francesca Guzzo; Simona Piemontese; Rebecca De Lorenzo; Valentina Da Prat; Monica Fedrizzi; Carolina Faustini; Martina Di Piazza; Francesca Conte; Rosalba Lembo; Antonio Esposito; Lorenzo Dagna; Giovanni Landoni; Alberto Zangrillo Journal: Acta Anaesthesiol Scand Date: 2021-03-15 Impact factor: 2.274
Authors: Alberto Zangrillo; Alessandro Belletti; Diego Palumbo; Maria Rosa Calvi; Francesca Guzzo; Evgeny V Fominskiy; Alessandro Ortalda; Pasquale Nardelli; Marco Ripa; Martina Baiardo Redaelli; Giovanni Borghi; Giovanni Landoni; Filippo D'Amico; Marilena Marmiere; Beatrice Righetti; Margherita Rocchi; Marco Saracino; Moreno Tresoldi; Lorenzo Dagna; Francesco De Cobelli Journal: J Cardiothorac Vasc Anesth Date: 2021-11-27 Impact factor: 2.628
Authors: Sarah Damanti; Giuseppe Alvise Ramirez; Enrica Paola Bozzolo; Valentina Da Prat; Giuseppe Di Lucca; Gaetano Di Terlizzi; Alessandro Marinosci; Raffaella Scotti; Silvia Strada; Paolo Scarpellini; Barbara Castiglioni; Chiara Oltolini; Marco Ripa; Chiara Tassan Din; Clarissa Elisabeth Centurioni; Flavia Di Scala; Agnese Gobbi; Ada Carla Alba; Giuseppina Maria Casiraghi; Anna Morgillo; Moreno Tresoldi Journal: Aging Clin Exp Res Date: 2022-03-17 Impact factor: 4.481
Authors: Barbara Bonnesen; Jens-Ulrik Stæhr Jensen; Klaus Nielsen Jeschke; Alexander G Mathioudakis; Alexandru Corlateanu; Ejvind Frausing Hansen; Ulla Møller Weinreich; Ole Hilberg; Pradeesh Sivapalan Journal: Diagnostics (Basel) Date: 2021-12-02