Introduction Corona virus disease (Covid-19) affects the airways and induces pulmonary lesions, patients with this disease require oxygen therapy as the disease progresses. Several oxygenation options have been used, l’HFNO had showed beneficial effects The objective of this study To evaluate the efficacy of high-flow nasal oxygen HFNO versus non-invasive ventilation in COVID-19. Methods This is a retrospective and comparative study conducted over a period of 10 months from March 2020 to December 2020 and involving 600 patients hospitalized in the intensive care unit of the CHU Mohammed VI of Oujda for the management of acute respiratory failure caused by COVID-19. Results Out of 600 patients with acute respiratory failure, 265 patients were included in the analyses. 162 (61.10%) patients were treated with HFNO, the intubation rate was 49.7% (80 patients out of 162) of which 63 died intubated (78.8%). Concerning the 82 non-intubated patients, only 16 died (19.8%). The total number of patients who received NIV was 71 (26.8%), 33 (46.5%) required mechanical ventilation. In-hospital mortality in patients treated with NIV was 100%. The difference in mortality outcome between the two groups was significantly (P < 0.0001) reduced in HFNO. Conclusions Treatment with high-flow oxygen improved survival in patients with acute hypoxemic respiratory failure compared with noninvasive ventilation, although no difference was observed in intubation rate
IntroductionThe COVID-19 pandemic continues to be rampant with considerable morbidity and mortality worldwide since its emergence in December 2019. Several studies have focused on identifying different predictive factors of poor prognosis, including biological markers, such as C Reactive Protein among others. The objective of our work was to determine whether the CRP levels on admission to the intensive care unit are predictive of an unfavorable evolution of patients with COVID-19 through the experience of the Anesthesia and Intensive Care Unit of the University Hospital of Oujda and to compare our results with those reported in the literature.MethodsWe conducted a retrospective, monocentric, descriptive and analytical study in the Department of Anesthesia and Intensive Care of the Mohammed VI University Hospital of Oujda, Morocco, between March 2020 and October 2021, including all critically ill patients admitted to the department during this period and meeting the inclusion criteria. The baseline admission CRP value was arbitrarily set at 100mg/d, thus conditioning the division of our patients into two groups (group 1: CRP < 100mg/L, group 2: CRP ≥ 100mg/L).ResultsAmong our 1035 included patients, 291 patients with had a CRP<100mlg/L (group 1) and 744 presented a CRP level equal or superior to 100mg/L (group 2). Lung parenchymal involvement was more severe or even critical (CT involvement > 75%) in group 2 (60.8%) compared to group 1 (39.2%). In group 2, 79.8% of patients were mechanically ventilated, compared to 20.2% of patients in group 1. Finally, the mortality rate in patients with a CRP ≥ 100mg/l was 77.4%, compared with 22.6% for patients with a CRP < 100mg/l. These findings are all statistically highly significant (p<0.001)ConclusionGiven the high contagiousness of the virus and the emergence of several variants, the management of the COVID-19 pandemic has focused more on prevention through vaccination against the virus, but also on an early identification of patients likely to evolve unfavorably for a personalized management.
Introduction Overall, patients with Sars-cov-2 disease treated with mechanical ventilation, which is not the case in our study. This report presents our first successful experience of awake ECMO application in a critical patient with hypoxemic Respiratory Failure related to COVID-19 infection in Morocco. Case management We have reported a 52-year-old female patient who was diagnosed with COVID-19 infection and progressed to critical cases. She was a candidate for applying awake extracorporeal membrane oxygenation (ECMO) in the absence of invasive mechanical ventilation, under local anesthesia alone with good progress and ventilatory weaning. Conclusion This therapeutic attitude can be beneficial for certain critical and severe cases due to COVID-19 infection. Each ECMO program should develop goals, methods, protocols, and best practices while adapting appropriately to the personnel and equipment available.
Introduction COVID-19 is an emerging infection, it is the first large-scale pandemic of the 21st century. Several complications have been described during this infection but spontaneous pneumothorax remains an uncommon complication, even more so in infants. Clinical presentation We report two cases of a 9-month-old and 18-month-old males admitted to our department for the management of an acute respiratory distress due to a COVID-19 infection associated to a spontaneous pneumothorax successfully drained. While one patient had a favorable outcome, the other was readmitted to our department for the management of a septic shock secondary to a urinary tract infection with a deadly outcome. Discussion In this paragraph we describe known causes behind spontaneous pneumothorax, before detailing the different pathogenesis hypotheses linking pneumothorax to COVID-19, all while comparing data to the literature related to the adult population. Conclusion Spontaneous pneumothorax is a serious complication associated with severe COVID-19 that can occur in infants and must be considered in the event of a respiratory aggravation or a persistent hypoxia.
Introduction the COVID-19 pandemic still accounts for thousands of cases every day. It's neurological involvement has been well documented most likely due to auto-immune mechanisms than the virus itself. Case report we report the case of a 38 years old women who developed an Acute Disseminated Encephalomyelitis following a COVID-19 infection, with a favorable outcome after immunosuppressive therapy. Discussion In this chapter, we discuss ADEM's pathogenesis as well as its clinical and radiological features before detailing its relationship with infectious and vaccination episodes. We also discuss how our patient disease evolved. Conclusion Acute Disseminated Encephalomyelitis is an immune-mediated disorder in which the widespread inflammation of the brain and spinal cord is responsible for a variety of symptoms. The novel COVID-19 virus and its vaccine are both a newly incriminated etiologies of this demyelinating disorder.
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