Bilevel and continuous positive airway pressure and factors linked to all-cause mortality in COVID-19 patients in an intermediate respiratory intensive care unit in Italy

COVID-19 clinical phenotypes and short-term outcomes: differences between the first and the second wave of pandemic in Italy

“…We performed a single-center, observational, retrospective study, enrolling patients with moderate-to-severe ARDS due to COVID-19 pneumonia [ 6 , 7 ] according to the Berlin definition, i.e., a respiratory failure characterized by arterial oxygen partial pressure to fractional inspired oxygen ratio (PaO 2 /FiO 2 ) <300 mmHg despite positive end-expiratory pressure (PEEP) >5 cmH 2 O, associated to bilateral chest opacities (not fully explained by effusions, lobar/lung collapse, or nodules) with an acute onset, within 1 week of a known clinical insult or new or worsening respiratory symptoms [ 8 ]. Our enrollment was carried out during the period from 11 March 2020 to 31 May 2020 and from 28 August 2020 to 15 October 2020 in our intermediate RICU, Policlinico Hospital, Bari, Italy.…”

More skilled clinical management of COVID-19 patients modified mortality in an intermediate respiratory intensive care unit in Italy

“…In the present single-centered, retrospective, observational study, we reported findings from 87 consecutive laboratory-confirmed COVID-19 patients, all with moderate-to-severe ARDS, hospitalized in an intermediate RICU [10,11] After initial screening at the Emergency Department, the patients were admitted to our intermediate RICU or in an ICU accordingly to the illness severity. The present study was approved by the Policlinico Hospital of University of Bari "Aldo Moro" institutional review board and informed consent was obtained from all subjects involved in the present analyses.…”

“…Although previous studies focused on clinical management with non-invasive respiratory support of COVID-19 patients in ICU [6][7][8], there is no evidence coming from an intermediate Respiratory Intensive Care Unit (RICU) or noninvasive respiratory care unit [8], a model of care designed for monitoring and treating respiratory patients whose illness is at a level of severity that is intermediate between that which requires ICU facilities and that which can be managed on a conventional ward. An intermediate RICU is an area for monitoring and treating patients with acute or exacerbated respiratory failure caused by a disease that is primarily respiratory [10,11]. While some studies investigated epidemiological and clinical features of laboratory-confirmed COVID-19 patients [6,12], limited attention has been paid to the follow-up of hospitalized patients on the basis of clinical setting and the expertise of clinical management.…”

Clinical Management of Adult Patients with COVID-19 Outside Intensive Care Units: Guidelines from the Italian Society of Anti-Infective Therapy (SITA) and the Italian Society of Pulmonology (SIP)

“…Mortality in patients treated with CPAP ranged from 14-24% [252,256,264,265,268,271] to 43-55% [254,260], although possibly reaching 84% when CPAP was the ceiling treatment [276]. Mortality in patients treated with NIV was reported in five studies and ranged from 5% to 52% (but reaching 86% in DNI patients) [261,263,269,272,274]. Pooling outcomes for the CPAP and NIV groups, Avdeev and colleagues estimated a mortality of 23% [255], and Bellani and colleagues estimated a mortality of 25% [270], while pooled results from Burns et al reported a 50% mortality among DNI patients [257].…”