Vergis Sara, Philip Sam, Paul Vergis, George Manjit, Philip Nevil C, Tomy Mithu
Department of Anaesthesiology and Critical Care, MOSC Medical College, Kerala, India.
Department of Surgery, MOSC Medical College, Kerala, India.
Acute Crit Care. 2023 May;38(2):182-189. doi: 10.4266/acc.2022.00206. Epub 2023 May 25.
Coronavirus disease 2019 (COVID-19) patients with acute respiratory failure who experience delayed initiation of invasive mechanical ventilation have poor outcomes. The lack of objective measures to define the timing of intubation is an area of concern. We investigated the effect of timing of intubation based on respiratory rate-oxygenation (ROX) index on the outcomes of COVID-19 pneumonia.
This was a retrospective cross-sectional study performed in a tertiary care teaching hospital in Kerala, India. Patients with COVID-19 pneumonia who were intubated were grouped into early intubation (within 12 hours of ROX index <4.88) or delayed intubation (12 hours or more hours after ROX <4.88).
A total of 58 patients was included in the study after exclusions. Among them, 20 patients were intubated early, and 38 patients were intubated 12 hours after ROX index <4.88. The mean age of the study population was 57±14 years, and 55.0% of the patients were male; diabetes mellitus (48.3%) and hypertension (50.0%) were the most common comorbidities. The early intubation group had 88.2% successful extubation, while only 11.8% of the delayed group had successful extubation (P<0.001). Survival was also significantly more frequent in the early intubation group.
Early intubation within 12 hours of ROX index <4.88 was associated with improved extubation and survival in patients with COVID-19 pneumonia.
2019冠状病毒病（COVID-19）合并急性呼吸衰竭的患者若延迟开始有创机械通气，预后较差。缺乏客观指标来确定插管时机是一个令人担忧的问题。我们研究了基于呼吸频率-氧合（ROX）指数的插管时机对COVID-19肺炎患者预后的影响。
这是一项在印度喀拉拉邦一家三级护理教学医院进行的回顾性横断面研究。将接受插管的COVID-19肺炎患者分为早期插管组（ROX指数<4.88后12小时内）和延迟插管组（ROX<4.88后12小时或更长时间）。
排除后，共有58例患者纳入研究。其中，20例患者早期插管，38例患者在ROX指数<4.88后12小时插管。研究人群的平均年龄为57±14岁，55.0%的患者为男性；糖尿病（48.3%）和高血压（50.0%）是最常见的合并症。早期插管组拔管成功率为88.2%，而延迟插管组仅11.8%成功拔管（P<0.001）。早期插管组的生存率也显著更高。
ROX指数<4.88后12小时内早期插管与COVID-19肺炎患者拔管成功率提高和生存率提高相关。
