Šitum Ivan, Hrvoić Lovro, Mamić Gloria, Džaja Nikolina, Popović Zvonimir, Karković Nikica, Jurković Ivan, Erceg Ante, Premužić Vedran, Mažar Mirabel, Mihaljević Slobodan, Perković Romana, Karmelić Dora, Lovrić Daniel
Department of Anaesthesiology, Reanimatology, Intensive Medicine and Pain Therapy, University Hospital Centre Zagreb, Zagreb, Croatia.
University of Zagreb School of Medicine, Zagreb, Croatia.
Disaster Med Public Health Prep. 2024 May 30;18:e97. doi: 10.1017/dmp.2024.85.
To investigate the efficacy and safety of non-invasive ventilation (NIV) with high PEEP levels application in patients with COVID-19-related acute respiratory distress syndrome (ARDS).
This is a retrospective cohort study with data collected from 95 patients who were administered NIV as part of their treatment in the COVID-19 intensive care unit (ICU) at University Hospital Centre Zagreb between October 2021 and February 2022. The definite outcome was NIV failure.
High PEEP NIV was applied in all 95 patients; 54 (56.84%) patients could be kept solely on NIV, while 41 (43.16%) patients required intubation. ICU mortality of patients solely on NIV was 3.70%, while total ICU mortality was 35.79%. The most significant difference in the dynamic of respiratory parameters between 2 patient groups was visible on Day 3 of ICU stay: By that day, patients kept solely on NIV required significantly lower PEEP levels and had better improvement in PaO, P/F ratio, and HACOR score.
High PEEP applied by NIV was a safe option for the initial respiratory treatment of all patients, despite the severity of ARDS. For some patients, it was also shown to be the only necessary form of oxygen supplementation.
探讨高呼气末正压（PEEP）水平的无创通气（NIV）在新型冠状病毒肺炎（COVID-19）相关急性呼吸窘迫综合征（ARDS）患者中的疗效和安全性。
这是一项回顾性队列研究，收集了2021年10月至2022年2月期间在萨格勒布大学医院中心COVID-19重症监护病房（ICU）接受NIV治疗的95例患者的数据。确定的结局为NIV失败。
95例患者均应用了高PEEP的NIV；54例（56.84%）患者仅依靠NIV即可维持，而41例（43.16%）患者需要插管。仅接受NIV治疗的患者ICU死亡率为3.70%，而总体ICU死亡率为35.79%。两组患者呼吸参数动态变化的最显著差异在入住ICU第3天可见：到那时，仅依靠NIV维持的患者所需PEEP水平显著较低，且动脉血氧分压（PaO）、氧合指数（P/F）和急性生理学与慢性健康状况评分系统Ⅱ（HACOR）评分改善更好。
尽管ARDS病情严重，但NIV应用高PEEP对所有患者的初始呼吸治疗是一种安全的选择。对于一些患者，它也被证明是唯一必要的氧疗形式。
