Role of Non-Invasive Respiratory Supports in COVID-19 Acute Respiratory Failure Patients with Do Not Intubate Orders

Medrinal, Clément; Gillet, Alexis; Boujibar, Fairuz; Dugernier, Jonathan; Zwahlen, Marcel; Lamia, Bouchra; Girault, Christophe; Créteur, Jacques; Fellrath, Jean-Marc; Haesler, Laurence; Lagache, Laurie; Macari, Elise Artaud; Taton, Olivier; Gouin, Philippe; Leduc, Dimitri; Hove, Olivier Van; Norrenberg, Michelle; Prieur, Guillaume; Combret, Yann; Correvon, Nils; Hilfiker, Roger; Contal, Olivier

doi:10.3390/jcm10132783

Cited by 7 publications

(10 citation statements)

References 35 publications

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“…We retrieved 3133 unique records, of which 200 were included in the review (Figure 1). All reasons for excluding records after full-text review are given in eAppendix 6 in Supplement 1.…”

Section: Resultsmentioning

confidence: 99%

Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials

Hansford,

Cashin,

Jones

et al. 2023

JAMA Netw Open

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ImportanceObservational (nonexperimental) studies that aim to emulate a randomized trial (ie, the target trial) are increasingly informing medical and policy decision-making, but it is unclear how these studies are reported in the literature. Consistent reporting is essential for quality appraisal, evidence synthesis, and translation of evidence to policy and practice.ObjectiveTo assess the reporting of observational studies that explicitly aimed to emulate a target trial.Evidence ReviewWe searched Medline, Embase, PsycINFO, and Web of Science for observational studies published between March 2012 and October 2022 that explicitly aimed to emulate a target trial of a health or medical intervention. Two reviewers double-screened and -extracted data on study characteristics, key predefined components of the target trial protocol and its emulation (eligibility criteria, treatment strategies, treatment assignment, outcome[s], follow-up, causal contrast[s], and analysis plan), and other items related to the target trial emulation.FindingsA total of 200 studies that explicitly aimed to emulate a target trial were included. These studies included 26 subfields of medicine, and 168 (84%) were published from January 2020 to October 2022. The aim to emulate a target trial was explicit in 70 study titles (35%). Forty-three studies (22%) reported use of a published reporting guideline (eg, Strengthening the Reporting of Observational Studies in Epidemiology). Eighty-five studies (43%) did not describe all key items of how the target trial was emulated and 113 (57%) did not describe the protocol of the target trial and its emulation.Conclusion and RelevanceIn this systematic review of 200 studies that explicitly aimed to emulate a target trial, reporting of how the target trial was emulated was inconsistent. A reporting guideline for studies explicitly aiming to emulate a target trial may improve the reporting of the target trial protocols and other aspects of these emulation attempts.

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“…We retrieved 3133 unique records, of which 200 were included in the review (Figure 1). All reasons for excluding records after full-text review are given in eAppendix 6 in Supplement 1.…”

Section: Resultsmentioning

confidence: 99%

Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials

Hansford,

Cashin,

Jones

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

show abstract

“…The patients included in the study were divided into two groups: patients who were considered for intubation (ICU-transferable) and patients who were not considered for intubation (not ICU-transferable). The decision not to intubate was made collegially and based on age, comorbidities and bed availability in the ICU of our institution [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

Development of a Medium Care Unit Using an Inexperienced Respiratory Staff: Lessons Learned during the COVID-19 Pandemic

Hove

Gillet

Tack

et al. 2022

IJERPH

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The different waves of the COVID-19 pandemic caused dramatic issues regarding the organization of care. In this context innovative solutions have to be developed in a timely manner to adapt to the organization of the care. The establishment of middle care (MC) units is a bright example of such an adaptation. A multidisciplinary MC team, including expert and non-expert respiratory health care personnel, was developed and trained to work in a COVID-19 MC unit. Important educational resources were set up to ensure rapid and effective training of the MC team, limiting the admission or delaying transfers to ICU and ensuring optimal management of palliative care. We conducted a retrospective analysis of patient data in the MC unit during the second COVID-19 wave in Belgium. The aim of this study was to demonstrate the feasibility of quickly developing an effective respiratory MC unit mixing respiratory expert and non-expert members from outside ICUs. The establishment of an MC unit during a pandemic is feasible and needed. MC units possibly relieve the pressure exerted on ICUs. A highly trained multidisciplinary team is key to ensuring the success of an MC unit during such kind of a pandemic.

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“…In any case, whether HFOT was used in patients as a ceiling therapy or as a first line for de novo respiratory failure, it was associated with lower mortality. However, it is not clear whether the patients included in the study underwent sequential escalation treatment in case of failure of high nasal flow ( 47 ). In a small study in elderly patients, after adjustment, HFOT was associated with less mortality than conventional oxygen therapy ( 48 ).…”

Section: Non-invasive Support Modalities Escalating Algorithms and The Role Of Combined Therapiesmentioning

confidence: 99%

Non-invasive Respiratory Support in COVID-19: A Narrative Review

et al. 2022

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Acute respiratory failure secondary to COVID-19 pneumonia may require a variety of non-pharmacological strategies in addition to oxygen therapy to avoid endotracheal intubation. The response to all these strategies, which include high nasal flow, continuous positive pressure, non-invasive ventilation, or even prone positioning in awake patients, can be highly variable depending on the predominant phenotypic involvement. Deciding when to replace conventional oxygen therapy with non-invasive respiratory support, which to choose, the role of combined methods, definitions, and attitudes toward treatment failure, and improved case improvement procedures are directly relevant clinical questions for the daily care of critically ill COVID-19 patients. The experience accumulated after more than a year of the pandemic should lead to developing recommendations that give answers to all these questions.

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Role of Non-Invasive Respiratory Supports in COVID-19 Acute Respiratory Failure Patients with Do Not Intubate Orders

Cited by 7 publications

References 35 publications

Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials

Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials

Development of a Medium Care Unit Using an Inexperienced Respiratory Staff: Lessons Learned during the COVID-19 Pandemic

Non-invasive Respiratory Support in COVID-19: A Narrative Review

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