Effect of noninvasive respiratory strategies on intubation or mortality among patients with acute hypoxemic respiratory failure and COVID-19: The RECOVERY-RS randomized clinical trial

Durr, Kevin M.; Yadav, Krishan; Rosenberg, Hans

doi:10.1007/s43678-022-00327-8

Cited by 4 publications

(5 citation statements)

References 4 publications

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Section: Discussionsupporting

confidence: 62%

“…The overall failure of the NIRS in other series varies between 40 and 60% [13,14,17,19], so our data are within the average of these margins. Focusing on mortality, the overall 32.5% was higher than the 26.6% reported by Franco et al, a study similar to ours, but lower than the 40.5% reported by Perkins et al [14]. However, when we analyzed only the therapies of HFNO and/or CPAP in terms of the failure between the study by Franco et al and ours, we observed very similar figures between both studies (47.7% vs. 46.5%), particularly for CPAP, but lower in our case when referring to HFNO (38% vs. 27.7%).…”

Section: Discussionsupporting

confidence: 62%

“…There is debate regarding which NIRS modality generates less failure. In previous studies that used NIRS, the failure rate was around 50% [12][13][14][15]. The therapy with the greatest failure is Bilevel, but there is controversy as to whether CPAP and high-flow therapy are superior to each other [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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Failure of Non-Invasive Respiratory Support in Patients with SARS-CoV-2

García-Fernández,

Sánchez-Nicolás,

Galicia-Puyol

et al. 2023

JCM

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Introduction: The objective of this study is to assess the failure of therapies with HFNO (high-flow nasal oxygen), CPAP, Bilevel, or combined therapy in patients with hypoxemic acute respiratory failure due to SARS-CoV-2 during their hospitalization. Methods: This was a retrospective and observational study of SARS-CoV-2-positive patients who required non-invasive respiratory support (NIRS) at the Reina Sofía General University Hospital of Murcia between March 2020 and May 2021. Results: Of 7355 patients, 197 (11.8%) were included; 95 of them failed this therapy (48.3%). We found that during hospitalization in the ward, the combined therapy of HFNO and CPAP had an overall lower failure rate and the highest treatment with Bilevel (p = 0.005). In the comparison of failure in therapy without two levels of airway pressure, HFNO, CPAP, and combined therapy of HFNO with CPAP, (35.6% of patients) presented with 24.2% failure, compared to those who had two levels of pressure with Bilevel and combined therapy of HFNO with Bilevel (64.4% of patients), with 75.8% associated failure (OR: 0, 374; CI 95%: 0.203–0.688. p = 0.001). Conclusions: The use of NIRS during conventional hospitalization is safe and effective in patients with respiratory failure secondary to SARS-CoV-2 infection. The therapeutic strategy of Bilevel increases the probability of failure, with the combined therapy strategy of CPAP and HFNO being the most promising option.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionsupporting

confidence: 62%

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Failure of Non-Invasive Respiratory Support in Patients with SARS-CoV-2

García-Fernández,

Sánchez-Nicolás,

Galicia-Puyol

et al. 2023

JCM

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“…RECOVERY-RS was a large trial evaluating 1273 patients randomized to use either CPAP or HFNC for acute respiratory failure with hypoxemia due to COVID-19 in comparison to conventional oxygen therapy. The primary outcomes of endotracheal intubation or 30-day mortality were significantly lower in patients receiving CPAP compared to conventional oxygen therapy, thus favoring CPAP as the initial strategy for managing respiratory failure in COVID-19 [ 324 ]. The results of this study need careful interpretation as it was terminated early and hence underpowered, coupled with the crossover between the groups.…”

Section: Reviewmentioning

confidence: 99%

From Emergence to Endemicity: A Comprehensive Review of COVID-19

Naik,

Avula,

Palleti

et al. 2023

Cureus

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Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), later renamed coronavirus disease 2019 (COVID-19), was first identified in Wuhan, China, in early December 2019. Initially, the China office of the World Health Organization was informed of numerous cases of pneumonia of unidentified etiology in Wuhan, Hubei Province at the end of 2019. This would subsequently result in a global pandemic with millions of confirmed cases of COVID-19 and millions of deaths reported to the WHO. We have analyzed most of the data published since the beginning of the pandemic to compile this comprehensive review of SARS-CoV-2. We looked at the core ideas, such as the etiology, epidemiology, pathogenesis, clinical symptoms, diagnostics, histopathologic findings, consequences, therapies, and vaccines. We have also included the long-term effects and myths associated with some therapeutics of COVID-19. This study presents a comprehensive assessment of the SARS-CoV-2 virology, vaccines, medicines, and significant variants identified during the course of the pandemic. Our review article is intended to provide medical practitioners with a better understanding of the fundamental sciences, clinical treatment, and prevention of COVID-19. As of May 2023, this paper contains the most recent data made accessible.

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“…Of the remaining 34 studies, 26 studies were excluded after full review, leaving eight studies. Among the studies excluded after full-text review, 19 were not RCTs, 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 two were conference abstracts, 27 , 28 and five did not meet inclusion criteria. 29 , 30 , 31 , 32 , 33 The Helmet-COVID RCT, comparing helmet-NIV vs usual respiratory support did not meet inclusion criteria because it included facemask-NIV as part of usual respiratory support.…”

Section: Resultsmentioning

confidence: 99%

High-flow nasal oxygen versus conventional oxygen therapy and noninvasive ventilation in COVID-19 respiratory failure: a systematic review and network meta-analysis of randomised controlled trials

Pisciotta,

Passannante,

Arina

et al. 2024

British Journal of Anaesthesia

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Effect of noninvasive respiratory strategies on intubation or mortality among patients with acute hypoxemic respiratory failure and COVID-19: The RECOVERY-RS randomized clinical trial

Cited by 4 publications

References 4 publications

Failure of Non-Invasive Respiratory Support in Patients with SARS-CoV-2

Failure of Non-Invasive Respiratory Support in Patients with SARS-CoV-2

From Emergence to Endemicity: A Comprehensive Review of COVID-19

High-flow nasal oxygen versus conventional oxygen therapy and noninvasive ventilation in COVID-19 respiratory failure: a systematic review and network meta-analysis of randomised controlled trials

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