Factors associated with non‐invasive positive pressure ventilation failure in a COVID‐19 intermediate care unit
Dublin Core
Title
Factors associated with non‐invasive positive pressure ventilation failure in a COVID‐19 intermediate care unit
Subject
Non-invasive ventilation, Respiratory insufficiency, COVID-19
Description
Background The use of non-invasive positive pressure ventilation (NIPPV) in COVID-19 patients with hypoxaemia
is still under debate. The aim was to evaluate the efficacy of NIPPV (CPAP, HELMET-CPAP or NIV) in COVID-19 patients
treated in the dedicated COVID-19 Intermediate Care Unit of Coimbra Hospital and University Centre, Portugal,
and to assess factors associated with NIPPV failure.
Methods Patients admitted from December 1st 2020 to February 28th 2021, treated with NIPPV due to COVID-19
were included. Failure was defined as orotracheal intubation (OTI) or death during hospital stay. Factors associated
with NIPPV failure were included in a univariate binary logistic regression analysis; those with a significance level
of p<0.001 entered a multivariate logistic regression model.
Results A total of 163 patients were included, 64.4% were males (n=105). The median age was 66 years (IQR 56–75).
NIPPV failure was observed in 66 (40.5%) patients, 26 (39.4%) were intubated and 40 (60.6%) died during their
hospital stay. The highest CRP (OR 1.164; 95%CI 1.036–1.308) and morphine use (OR 24.771; 95%CI 1.809–339.241)
were identified as predictors of failure after applying multivariate logistic regression. Adherence to prone positioning
(OR 0.109; 95%CI 0.017–0.700) and a higher value of the lowest platelet count during hospital stay (OR 0.977; 95%CI
0.960–0.994) were associated with a favorable outcome.
Conclusions NIPPV was successful in over half of patients. Highest CRP during hospital stay and morphine use were
predictors of failure. Adherence to prone positioning and a higher value of the lowest platelet count during hospital
stay were associated with a favourable outcome.
is still under debate. The aim was to evaluate the efficacy of NIPPV (CPAP, HELMET-CPAP or NIV) in COVID-19 patients
treated in the dedicated COVID-19 Intermediate Care Unit of Coimbra Hospital and University Centre, Portugal,
and to assess factors associated with NIPPV failure.
Methods Patients admitted from December 1st 2020 to February 28th 2021, treated with NIPPV due to COVID-19
were included. Failure was defined as orotracheal intubation (OTI) or death during hospital stay. Factors associated
with NIPPV failure were included in a univariate binary logistic regression analysis; those with a significance level
of p<0.001 entered a multivariate logistic regression model.
Results A total of 163 patients were included, 64.4% were males (n=105). The median age was 66 years (IQR 56–75).
NIPPV failure was observed in 66 (40.5%) patients, 26 (39.4%) were intubated and 40 (60.6%) died during their
hospital stay. The highest CRP (OR 1.164; 95%CI 1.036–1.308) and morphine use (OR 24.771; 95%CI 1.809–339.241)
were identified as predictors of failure after applying multivariate logistic regression. Adherence to prone positioning
(OR 0.109; 95%CI 0.017–0.700) and a higher value of the lowest platelet count during hospital stay (OR 0.977; 95%CI
0.960–0.994) were associated with a favorable outcome.
Conclusions NIPPV was successful in over half of patients. Highest CRP during hospital stay and morphine use were
predictors of failure. Adherence to prone positioning and a higher value of the lowest platelet count during hospital
stay were associated with a favourable outcome.
Creator
Inês Farinha1*, Alexandra Tenda da Cunha1
, Ana Rita Nogueira2,3, André Ribeiro3,4, Carlos Silva3,5, João Rua2,3,
João Trêpa3,6, José Eduardo Mateus2,3 and Filipa Costa1,3
, Ana Rita Nogueira2,3, André Ribeiro3,4, Carlos Silva3,5, João Rua2,3,
João Trêpa3,6, José Eduardo Mateus2,3 and Filipa Costa1,3
Source
https://doi.org/10.1186/s12245-023-00510-3
Date
2023
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Inês Farinha1*, Alexandra Tenda da Cunha1
, Ana Rita Nogueira2,3, André Ribeiro3,4, Carlos Silva3,5, João Rua2,3,
João Trêpa3,6, José Eduardo Mateus2,3 and Filipa Costa1,3, “Factors associated with non‐invasive positive pressure ventilation failure in a COVID‐19 intermediate care unit,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12143.