Authors` response to “Efficacy of noninvasive ventilation in patients with COVID-19”

Polok, Kamil; Fronczek, Jakub; Szczeklik, Wojciech

doi:10.1186/s13054-022-04267-8

Cited by 4 publications

(5 citation statements)

References 4 publications

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“…NIV is used broadly in most of the ICUs. According to Polok et al international survey, NIV is applied as the primary respiratory support modality or after extubation [12 ▪▪ ]. The use of NIV varies largely between countries and centers and is reported to be between 1% and 62% of the patients.…”

Section: Nutrition In Non-invasive Ventilationmentioning

confidence: 99%

“…The use of NIV varies largely between countries and centers and is reported to be between 1% and 62% of the patients. Frail patients received NIV therapy more often as primary support than after extubation [12 ▪▪ ], however, there is no clear advantage to using NIV in acute respiratory distress syndrome (ARDS) according to the recent ESICM guidelines [13 ▪▪ ]. A meta-analysis did not identify a significant effect of NIV compared to control therapy on intubation [relative risk (RR) 0.89, 95% confidence interval (CI) 0.77–1.03] or hospital mortality (RR 0.89, 95% CI 0.75–1.05) [13 ▪▪ ].…”

Section: Nutrition In Non-invasive Ventilationmentioning

confidence: 99%

“…The use of noninvasive ventilation (NIV) and high-flow nasal cannula (HFNC) oxygen therapy has been increasing in recent years in patients with acute respiratory distress in the intensive care setting, but also in internal medicine wards [1–3]. NIV has been shown to be an effective treatment for acute hypercapnic respiratory failure (AHRF), particularly in chronic obstructive pulmonary disease (COPD).…”

Section: Introductionmentioning

confidence: 99%

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Nutrition during noninvasive respiratory support

Singer,

Robinson,

Hellerman-Itzhaki

2024

Current Opinion in Critical Care

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Purpose of review The use of noninvasive techniques [noninvasive ventilation (NIV) or high flow nasal cannula (HFNC) oxygen therapy] to support oxygenation and/or ventilation in patients with respiratory failure has become widespread, even more so since the coronavirus disease 2019 pandemic. The use of these modalities may impair the patient's ability to eat. “To breath or to eat” may become a dilemma. In this review, we identify the patients at risk of malnutrition that require medical nutritional therapy and understand the mechanisms of function of the devices to better give adapted nutritional indications for noninvasive ventilation or high flow nasal cannula. Recent findings The Global Leadership Initiative for Malnutrition has been validated in the Intensive Care setting and can be used in patients requiring NIV. Many patients are underfed when receiving noninvasive ventilation therapies. HFNC may impair the swallowing ability and increase dysphagia while NIV may improve the swallowing reflexes. New technology preventing reflux and ensuring enteral feeding efficacy may increase the medical nutrition therapy safety and provide near-target energy and protein provision. Summary The patient requiring noninvasive ventilation presents one of the most challenging nutritional challenges. The main steps to improve nutrition administration are to assess nutritional status, evaluate the presence of dysphagia, choose the most adequate tool of respiratory support, and adapt nutritional therapy (oral, enteral, or parenteral) accordingly.

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Section: Nutrition In Non-invasive Ventilationmentioning

confidence: 99%

Section: Nutrition In Non-invasive Ventilationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nutrition during noninvasive respiratory support

Singer,

Robinson,

Hellerman-Itzhaki

2024

Current Opinion in Critical Care

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“…[4][5][6][7][8] The use of noninvasive respiratory support in particular, such as with heated, humidified high-flow nasal oxygen (HFNO) or noninvasive ventilation (NIV), increased dramatically after reports initially overestimated mortality in COVID-19 patients on mechanical ventilation. [9][10][11] Subsequent analyses found delaying intubation in patients with COVID-19-associated respiratory failure was associated with higher mortality, [12][13][14][15][16][17] perhaps due to patient self-inflicted lung injury (P-SILI). 8,18 We aimed to analyze the effect of pre-ECMO use of HFNO, NIV, and IMV on mortality in patients requiring ECMO for COVID-19-related ARDS.…”

mentioning

confidence: 99%

Advanced Respiratory Support Days as a Novel Marker of Mortality in COVID-19 Acute Respiratory Distress Syndrome Requiring Extracorporeal Membrane Oxygenation

Grotberg,

Kraft,

Sullivan

et al. 2024

ASAIO Journal

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Emerging evidence suggests prolonged use of noninvasive respiratory support may increase mortality of patients with coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome who require extracorporeal membrane oxygenation (ECMO). Using a database of adults receiving ECMO for COVID-19, we calculated survival curves and multivariable Cox regression to determine the risk of death associated with pre-ECMO use of high-flow nasal oxygen (HFNO), noninvasive ventilation (NIV), and invasive mechanical ventilation (IMV) days. We investigated the performance of a novel variable, advanced respiratory support days (composite of HFNO, NIV, and IMV days), on Respiratory ECMO Survival Prediction (RESP) score. Subjects (N = 146) with increasing advanced respiratory support days (<5, 5-9, and ≥10) had a stepwise increase in 90 day mortality (32.2%, 57.7%, and 75.4%, respectively; p = 0.002). Ninety-day mortality was significantly higher in subjects (N = 121) receiving NIV >4 days (81.8% vs. 52.4%, p < 0.001). Each additional pre-ECMO advanced respiratory support day increased the odds of right ventricular failure (odds ratio [OR]: 1.066, 95% confidence interval [CI]: 1.002–1.135) and in-hospital mortality (1.17, 95% CI: 1.08–1.27). Substituting advanced respiratory support days for IMV days improved RESP score mortality prediction (area under the curve (AUC) or: 0.64 vs. 0.71). Pre-ECMO advanced respiratory support days were associated with increased 90 day mortality compared with IMV days alone. Adjusting the RESP score for advanced respiratory support days improved mortality prediction.

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“…The failure of "very early" intubation at the outset of the pandemic, and the subsequent overestimated mortality from using IMV, likely led to significantly increased use of NIV and HFNO for longer durations to avoid intubation. However, accumulating evidence suggests "delaying" intubation in patients with COVID-19-associated respiratory failure is also associated with a higher mortality (21)(22)(23)(24)(25). In a cohort of 574 ICU patients with COVID-19, "very late" intubation (beyond 5 d of HFNO or NIV initiation) had Commentary the rate of mortality (87%) (26).…”

mentioning

confidence: 99%

Timing of Intubation in COVID-19: When It Is Too Early and When It Is Too Late

Grotberg

Kraft

2023

Critical Care Explorations

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The timing of initiating mechanical ventilation in patients with acute respiratory distress syndrome due to COVID-19 remains controversial. At the outset of the pandemic, "very early" intubation was recommended in patients requiring oxygen flows above 6 L per minute but was followed closely thereafter by avoidance of invasive mechanical ventilation (IMV) due to a perceived (yet overestimated) risk of mortality after intubation. While the use of noninvasive methods of oxygen delivery, such as high-flow nasal oxygen (HFNO) or noninvasive positive pressure ventilation (NIV), can avert the need for mechanical ventilation in some, accumulating evidence suggests delayed intubation is also associated with an increased mortality in a subset of COVID-19 patients. Close monitoring is necessary in COVID-19 patients on HFNO or NIV to identify signs of noninvasive failure and ensure appropriate provision of IMV.

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Authors` response to “Efficacy of noninvasive ventilation in patients with COVID-19”

Cited by 4 publications

References 4 publications

Nutrition during noninvasive respiratory support

Nutrition during noninvasive respiratory support

Advanced Respiratory Support Days as a Novel Marker of Mortality in COVID-19 Acute Respiratory Distress Syndrome Requiring Extracorporeal Membrane Oxygenation

Timing of Intubation in COVID-19: When It Is Too Early and When It Is Too Late

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