A Retrospective Analysis of Ventilatory Strategy Comparing Non-invasive Ventilation (NIV) With Invasive Ventilation in Patients Admitted With Severe COVID-19 Pneumonia

Abstract

BackgroundThe second wave of the COVID-19 pandemic in India saw a sudden upsurge of critically ill patients getting admitted to the ICU. The guidance for respiratory support was unclear in the early phase. But later reports showed lower mortality with non-invasive ventilation (NIV) than with intubation. The aim of this study was to assess the end result of initial methods of ventilation in COVID-19 patients. MethodologyPatients admitted to ICU with COVID-19 were categorized as group 1 (IPPV-intubated within 24 hrs of admission), group 2 (NIV -NIV only), group 3 (NIV+ IPPV-intubated after 24 hrs), and group 4 (NRBM -Non-Rebreathing Mask only). All causes in the hospital or 30-day mortality, length of stay in ICU, and incidence of pneumothorax were compared between groups. Logistic regression analysis was done to determine the odds of mortality. ResultsThe overall mortality rate among patients admitted to tertiary care centers was 15% and the rate among patients in ICU was 54.07%. Patients in group 1 and group 3 had significantly high mortality rates of 90.47% and 93.75%, respectively, as compared to 51.28% in group 2 patients. The odds of mortality were high in

Analysis of an Individualised Stepwise Approach to Non-Pharmacological Therapy in COVID-19

“…It can lead to acute respiratory distress syndrome (ARDS), necessitating invasive mechanical ventilation (IMV) among other modes of intensive care support, which is associated with a high mortality [ 4 ]. There is a growing evidence base for the use of conventional oxygen therapy (COT), high-flow nasal cannula (HFNC) [ 5 , 6 ], continuous positive airway pressure (CPAP) [ 7 ], and non-invasive ventilation (NIV) [ 8 , 9 ] to improve oxygenation and treat respiratory distress in COVID-19, potentially delaying intubation and, in some cases, making intubation unnecessary [ 10 , 11 ].…”