Response of patients with acute respiratory failure caused by COVID-19 to awake-prone position outside the intensive care unit based on pulmonary involvement

Silva, João Manoel da; Treml, Ricardo Esper; Golinelli, Pamela Cristina; Segundo, Miguel Rogério de Melo Gurgel; Menezes, Pedro Ferro L; Umada, Julilane Daniele de Almeida; Alves, Ana Paula Santana; Nabeshima, Renata Peres; Carvalho, André dos Santos; Pereira, Talison Silas; Sponton, Elaine Serafim

doi:10.6061/clinics/2021/e3368

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…Further, this group showed worse respiratory parameters as higher needs of FiO 2 and PEEP than those with lesser lung parenchymal involvement. Our findings were comparable to the multicenter observational study PRoVENT-COVID-19 and other studies which showed worse pulmonary parameters in critically ill patients with COVID-19 with severe lung involvement, especially in patients with more than 40% lung parenchyma involvement [ 3 , 32 , 33 ]. The results obtained may serve as a confirmation of the utility of Chest-CTSS) in predicting respiratory outcomes among critically ill patients with COVID-19 in the ICU setting.…”

Section: Discussionsupporting

confidence: 90%

“…critically ill patients with COVID-19 with severe lung involvement, especially in patients with more than 40% lung parenchyma involvement [3,32,33]. The results obtained may serve as a confirmation of the utility of Chest-CTSS) in predicting respiratory outcomes among critically ill patients with COVID-19 in the ICU setting.…”

Section: Plos Onementioning

confidence: 57%

“…Severe coronavirus disease 19 (severe COVID-19) has brought many challenges to Intensive Care Units (ICU) since December 2019 [1][2][3]. Chest computed tomography imaging (Chest-CT) played an important role not only in the correct early diagnosis of the infection of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) but also served as a pivotal tool to screening of disease severity in COVID-19 patients during the pandemic [4,5].…”

Section: Introductionmentioning

confidence: 99%

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Association of chest computed tomography severity score at ICU admission and respiratory outcomes in critically ill COVID-19 patients

Esper Treml,

Caldonazo,

Barlem Hohmann

et al. 2024

PLoS ONE

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Objective To evaluate the association of a validated chest computed tomography (Chest-CT) severity score in COVID-19 patients with their respiratory outcome in the Intensive Care Unit. Methods A single-center, prospective study evaluated patients with positive RT-PCR for COVID-19, who underwent Chest-CT and had a final COVID-19 clinical diagnosis needing invasive mechanical ventilation in the ICU. The admission chest-CT was evaluated according to a validated Chest-CT Severity Score in COVID-19 (Chest-CTSS) divided into low ≤50% (<14 points) and >50% high (≥14 points) lung parenchyma involvement. The association between the initial score and their pulmonary clinical outcomes was evaluated. Results 121 patients were clustered into the > 50% lung involvement group and 105 patients into the ≤ 50% lung involvement group. Patients ≤ 50% lung involvement (<14 points) group presented lower PEEP levels and FiO2 values, respectively GEE P = 0.09 and P = 0.04. The adjusted COX model found higher hazard to stay longer on invasive mechanical ventilation HR: 1.69, 95% CI, 1.02–2.80, P = 0.042 and the adjusted logistic regression model showed increased risk ventilator-associated pneumonia OR = 1.85 95% CI 1.01–3.39 for COVID-19 patients with > 50% lung involvement (≥14 points) on Chest-CT at ICU admission. Conclusion COVID-19 patients with >50% lung involvement on Chest-CT admission presented higher chances to stay longer on invasive mechanical ventilation and more chances to developed ventilator-associated pneumonia.

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Section: Discussionsupporting

confidence: 90%

Section: Plos Onementioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

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Association of chest computed tomography severity score at ICU admission and respiratory outcomes in critically ill COVID-19 patients

Esper Treml,

Caldonazo,

Barlem Hohmann

et al. 2024

PLoS ONE

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Effect of restrictive cumulative fluid balance on 28-day survival in invasively ventilated patients with moderate to severe ARDS due to COVID-19

Esper Treml,

Caldonazo,

Filho

et al. 2023

Sci Rep

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This study aimed to evaluate the effect of two restrictive cumulative fluid balance (CFB) trends on survival and on major clinical outcomes in invasively ventilated patients with moderate to severe respiratory distress syndrome (ARDS) due to SARS-CoV-2. Prospective data collection was conducted on patients in the intensive care unit (ICU) originating from a tertiary university hospital. The primary outcomes were the risk association between the CFB trend during D0 to D7 and 28-day survival. The secondary outcomes were ICU mortality, in-hospital mortality, the need for invasive ventilation at D28, administration of vasoactive drugs at D7, time on invasive ventilation after D7, and length of ICU and hospital stay. 171 patients were enrolled in the study and divided according to their CFB trends during seven days of follow-up using model-based clustering [median CFB negative trend (n = 89) – 279 ml (− 664 to 203) and (n = 82) median CFB positive trend 1362 ml (619–2026)]. The group with CFB negative trend showed a higher chance of surviving 28-day in the ICU (HR: 0.62, 95% CI 0.41–0.94, p = 0.038). Moreover, this group had a reduced length of stay in the ICU, 11 (8–19) days versus 16.5 (9–29) days p = 0.004 and presented lower rates (OR = 0.22; 95% CI 0.09–0.52) of invasive ventilation after 28-days in the ICU. In patients invasively ventilated with moderate to severe ARDS due to COVID-19, the collective who showed a negative trend in the CFB after seven days of invasive ventilation had a higher chance of surviving 28 days in the ICU and lower length of stay in the ICU.

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Prone positioning in awake patients without ventilatory support does not alter major clinical outcomes in severe COVID-19: results from a retrospective observational cohort study, systematic review and meta-analysis

Freire,

Barros,

Valente

et al. 2024

Expert Review of Respiratory Medicine

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Response of patients with acute respiratory failure caused by COVID-19 to awake-prone position outside the intensive care unit based on pulmonary involvement

Cited by 3 publications

References 30 publications

Association of chest computed tomography severity score at ICU admission and respiratory outcomes in critically ill COVID-19 patients

Association of chest computed tomography severity score at ICU admission and respiratory outcomes in critically ill COVID-19 patients

Effect of restrictive cumulative fluid balance on 28-day survival in invasively ventilated patients with moderate to severe ARDS due to COVID-19

Prone positioning in awake patients without ventilatory support does not alter major clinical outcomes in severe COVID-19: results from a retrospective observational cohort study, systematic review and meta-analysis

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