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Efficacy and Safety of High PEEP NIV in COVID-19 Patients

Published online by Cambridge University Press:  30 May 2024

Ivan Šitum Open the ORCID record for Ivan Šitum [Opens in a new window] ,
Lovro Hrvoić Open the ORCID record for Lovro Hrvoić [Opens in a new window] ,
Gloria Mamić Open the ORCID record for Gloria Mamić [Opens in a new window] ,
Nikolina Džaja Open the ORCID record for Nikolina Džaja [Opens in a new window] ,
Zvonimir Popović Open the ORCID record for Zvonimir Popović [Opens in a new window] ,
Nikica Karković Open the ORCID record for Nikica Karković [Opens in a new window] ,
Ivan Jurković Open the ORCID record for Ivan Jurković [Opens in a new window] ,
Ante Erceg Open the ORCID record for Ante Erceg [Opens in a new window] ,
Vedran Premužić Open the ORCID record for Vedran Premužić [Opens in a new window]  and
Mirabel Mažar Open the ORCID record for Mirabel Mažar [Opens in a new window]
...Show all authors
Ivan Šitum
Affiliation:
Department of Anaesthesiology, Reanimatology, Intensive Medicine and Pain Therapy, University Hospital Centre Zagreb, Zagreb, Croatia
Lovro Hrvoić
Affiliation:
University of Zagreb School of Medicine, Zagreb, Croatia
Gloria Mamić
Affiliation:
Department of Anaesthesiology, Reanimatology, Intensive Medicine and Pain Therapy, University Hospital Centre Zagreb, Zagreb, Croatia
Nikolina Džaja*
Affiliation:
Department of Anaesthesiology, Reanimatology, Intensive Medicine and Pain Therapy, University Hospital Centre Zagreb, Zagreb, Croatia
Zvonimir Popović
Affiliation:
Department of Neurology, University Hospital Centre Osijek and University of Osijek School of Medicine, Osijek, Croatia
Nikica Karković
Affiliation:
Department of Anaesthesiology, Reanimatology, Intensive Medicine and Pain Therapy, University Hospital Centre Zagreb, Zagreb, Croatia
Ivan Jurković
Affiliation:
Department of Anaesthesiology, Reanimatology, Intensive Medicine and Pain Therapy, University Hospital Centre Zagreb, Zagreb, Croatia
Ante Erceg
Affiliation:
Department of Anaesthesiology, Reanimatology, Intensive Medicine and Pain Therapy, University Hospital Centre Zagreb, Zagreb, Croatia
Vedran Premužić
Affiliation:
Department of Nephrology, University Hospital Centre Zagreb, Zagreb, Croatia
Mirabel Mažar
Affiliation:
Department of Anaesthesiology, Reanimatology, Intensive Medicine and Pain Therapy, University Hospital Centre Zagreb, Zagreb, Croatia
Slobodan Mihaljević
Affiliation:
Department of Anaesthesiology, Reanimatology, Intensive Medicine and Pain Therapy, University Hospital Centre Zagreb, Zagreb, Croatia
Romana Perković
Affiliation:
Department of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia
Dora Karmelić
Affiliation:
Department of Anaesthesiology, Reanimatology, Intensive Medicine and Pain Therapy, University Hospital Centre Zagreb, Zagreb, Croatia
Daniel Lovrić
Affiliation:
Department of Cardiology, University Hospital Centre Zagreb, Zagreb, Croatia
*
Corresponding author: Nikolina Džaja; Email: nikolina.golem96@gmail.com.
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Abstract

Objective:

To investigate the efficacy and safety of non-invasive ventilation (NIV) with high PEEP levels application in patients with COVID–19–related acute respiratory distress syndrome (ARDS).

Methods:

This is a retrospective cohort study with data collected from 95 patients who were administered NIV as part of their treatment in the COVID-19 intensive care unit (ICU) at University Hospital Centre Zagreb between October 2021 and February 2022. The definite outcome was NIV failure.

Results:

High PEEP NIV was applied in all 95 patients; 54 (56.84%) patients could be kept solely on NIV, while 41 (43.16%) patients required intubation. ICU mortality of patients solely on NIV was 3.70%, while total ICU mortality was 35.79%. The most significant difference in the dynamic of respiratory parameters between 2 patient groups was visible on Day 3 of ICU stay: By that day, patients kept solely on NIV required significantly lower PEEP levels and had better improvement in PaO2, P/F ratio, and HACOR score.

Conclusion:

High PEEP applied by NIV was a safe option for the initial respiratory treatment of all patients, despite the severity of ARDS. For some patients, it was also shown to be the only necessary form of oxygen supplementation.

Keywords

ARDScontinuous positive airway pressureCOVID-19non-invasive ventilationPEEP
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 18 , 2024 , e97
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

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