Cumulative oxygen deficit is a novel predictor for the timing of invasive mechanical ventilation in COVID-19 patients with respiratory distress

PeerJ

article

Huiqing Ge¹  Jian-cang Zhou²  FangFang Lv³  Junli Zhang³  Jun Yi⁴  Changming Yang⁵  Lingwei Zhang⁶  Yuhan Zhou⁶  Binbin Ren⁷  Qing Pan⁶  Zhongheng Zhang⁸ 

[1] Department of Respiratory Care, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine;Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine;Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine;Thoracic Cardiovascular Surgery, Jingmen First People’s Hospital;Department of Anesthesiology, The First People’s of Hospital of Jingmen City;College of Information Engineering, Zhejiang University of Technology;Department of Infectious Disease, Jinhua Municipal Central Hospiltal, Affiliated Jinhua Hospital, Zhejiang University School of Medicine;Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine

关键词: COVID-19;    Mechanical ventilation;    Intubation;    Oxygenation;   

DOI  :  10.7717/peerj.10497

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

Background and objectives The timing of invasive mechanical ventilation (IMV) is controversial in COVID-19 patients with acute respiratory hypoxemia. The study aimed to develop a novel predictor called cumulative oxygen deficit (COD) for the risk stratification. Methods The study was conducted in four designated hospitals for treating COVID-19 patients in Jingmen, Wuhan, from January to March 2020. COD was defined to account for both the magnitude and duration of hypoxemia. A higher value of COD indicated more oxygen deficit. The predictive performance of COD was calculated in multivariable Cox regression models. Results A number of 111 patients including 80 in the non-IMV group and 31 in the IMV group were included. Patients with IMV had substantially lower PaO2 (62 (49, 89) vs. 90.5 (68, 125.25) mmHg; p < 0.001), and higher COD (−6.87 (−29.36, 52.38) vs. −231.68 (−1040.78, 119.83) mmHg·day) than patients without IMV. As compared to patients with COD 30 mmHg·day had higher risk of fatality (HR: 3.79, 95% CI [2.57–16.93]; p 50 mmHg·day were 10 times more likely to die (HR: 10.45, 95% CI [1.28–85.37]; p = 0.029). Conclusions The study developed a novel predictor COD which considered both magnitude and duration of hypoxemia, to assist risk stratification of COVID-19 patients with acute respiratory distress.

【 授权许可】

CC BY