Authors:
Tommaso Pettenuzzo, Chiara Giraudo, Giulia Fichera, Michele Della Paolera, Martina Tocco, Michael Weber, Davide Gorgi, Silvia Carlucci, Federico Lionello, Sara Lococo, Annalisa Boscolo, Alessandro De Cassai, Laura Pasin, Marco Rossato, Andrea Vianell (...)
Tommaso Pettenuzzo, Chiara Giraudo, Giulia Fichera, Michele Della Paolera, Martina Tocco, Michael Weber, Davide Gorgi, Silvia Carlucci, Federico Lionello, Sara Lococo, Annalisa Boscolo, Alessandro De Cassai, Laura Pasin, Marco Rossato, Andrea Vianello, Roberto Vettor, Nicolò Sella, Paolo Navalesi
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Abstract:
Forms of noninvasive respiratory support (NIRS) have been widely used to avoid endotracheal intubation in patients with coronavirus disease-19 (COVID-19). However, inappropriate prolongation of NIRS may delay endotracheal intubation and worsen patient outcomes. The aim of this retrospective study was to assess whether the CARE score, a chest X-ray score previously validated in COVID-19 patients, may predict the need for endotracheal intubation and escalation of respiratory support in COVID-19 patients requiring NIRS. From December 2020 to May 2 (...)
Forms of noninvasive respiratory support (NIRS) have been widely used to avoid endotracheal intubation in patients with coronavirus disease-19 (COVID-19). However, inappropriate prolongation of NIRS may delay endotracheal intubation and worsen patient outcomes. The aim of this retrospective study was to assess whether the CARE score, a chest X-ray score previously validated in COVID-19 patients, may predict the need for endotracheal intubation and escalation of respiratory support in COVID-19 patients requiring NIRS. From December 2020 to May 2021, we included 142 patients receiving NIRS who had a first chest X-ray available at NIRS initiation and a second one after 48–72 h. In 94 (66%) patients, the level of respiratory support was increased, while endotracheal intubation was required in 83 (58%) patients. The CARE score at NIRS initiation was not predictive of the need for endotracheal intubation (odds ratio (OR) 1.01, 95% confidence interval (CI) 0.96–1.06) or escalation of treatment (OR 1.01, 95% CI 0.96–1.07). In conclusion, chest X-ray severity, as assessed by the CARE score, did not allow predicting endotracheal intubation or escalation of respiratory support in COVID-19 patients undergoing NIRS.
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