The following is a summary of “Noninvasive Ventilation for Moderate to Severe Acute Respiratory Distress Syndrome Due to COVID-19,” published in the July 2024 issue of Critical Care by Botsch et al.
The use of noninvasive ventilation (NIV) in patients with acute respiratory distress syndrome (ARDS) has sparked debate, exacerbated by the challenges of the COVID-19 pandemic’s global patient surge and strain on resources.
Researchers conducted a retrospective study investigating whether adults requiring NIV with moderate to severe COVID-19 ARDS impacted the need for intubation and hospital death rates.
They enrolled adult patients from an institutional COVID-19 registry, specifically those admitted to the hospital between March 2020 and March 2022, who developed moderate to severe ARDS. Primary endpoints included intubation rates and in-hospital mortality among patients treated with either NIV or MV. Additionally, the success rate of NIV was investigated by avoiding the need for intubation.
The result showed 823 eligible patients, with 454 (55.2%) not receiving NIV and 369 (44.8%) receiving NIV. Patients who received NIV were more likely to progress to requiring MV. For individuals needing endotracheal intubation, the use of NIV was associated with increased mortality rates. Additionally, patients with NIV had lower severity-adjusted odds of surviving without intubation in comparison with patients without NIV.
Investigators concluded that patients diagnosed with moderate to severe ARDS due to SARS-CoV-2 pneumonia and treated with NIV, experienced heightened risks of advancing to endotracheal intubation and in-hospital mortality.
