The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a public health crisis that has resulted in the death of thousands within the United States. The large influx of patients requiring mechanical ventilation for acute respiratory distress syndrome (ARDS) has necessitated the utilization of ventilators from a variety of sources. We hypothesized that ventilator model may be an independent risk factor for mortality in mechanically ventilated patients with COVID-19. METHODS: We retrospectively reviewed the medical records of 147 patients admitted to the adult intensive care unit of a tertiary hospital [New York Presbyterian Queens (NYPQ), Flushing, NY] from 1 March 2020 to 2 April 2020 in whom COVID-19 was confirmed and mechanical ventilation was initiated. Patients <18 years old were excluded as were patients who were pregnant. Diagnosis of COVID-19 was based on a positive result from a probe-based reverse transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 from a nasopharyngeal swab. This observational retrospective study without any specific intervention was reviewed and exempted by the hospital Institutional Review Board, and all data were deidentified prior to processing.
After the novel coronavirus disease (COVID-19), was declared a pandemic, New York quickly became the new epicenter of the disease, with Queens County reporting the most confirmed cases in the United States. This study was conducted during the peak of COVID-19 in Queens. Due to the severity of the disease and limited resources, patients were intubated at varying degrees of oxygenation. This study examines the preoxygenation state of COVID-19 ARDS patients prior to intubation and its implication on clinical outcomes. METHODS: At a single acute tertiary care hospital located in Queens, New York, all patients admitted between March 15 and April 15, 2020 were screened. Active COVID-19 status was confirmed with reverse transcriptase-polymerase chain reaction assay on nasopharyngeal samples. All COVID-19 patients who were intubated with documented pre-intubation oxygen saturation (PreO2) were included. All data were collected from the electronic health record, including laboratory data, ventilator settings, and hospital course. Peri-intubation cardiac arrest events up to 24 hours post-intubation and mortality during the study period were examined as outcomes. Data was analyzed with SPSS (version 25). Continuous variables were tested using independent Ttests. All tests of significance were two-tailed, and a p-value of 0.05 was considered significant.
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