Dataset Information

Preventing Severe Acute Respiratory Syndrome Coronavirus-2 Exhalation Upon Tracheal Extubation in the Intensive Care Unit: A Case Series.

ABSTRACT: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a highly infectious virus transmitted by inhalation of infected matter containing live virus or by exposure from contaminated surfaces. Aerosol-generating procedures (AGPs) create an increased risk of airborne transmission of infection. Tracheal extubation of coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU) is a risky AGP procedure owing to the proximity of the staff members to the patients' mouths and the exposure to airway secretions. We describe the use of a disposable openable mask (Janus Mask, Biomedical Srl, Florence, Italy) that might limit aerosol generation in the periextubation phase of COVID-19 cardiac surgical patients.

SUBMITTER: Guarracino F

PROVIDER: S-EPMC8330624 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Preventing Severe Acute Respiratory Syndrome Coronavirus-2 Exhalation Upon Tracheal Extubation in the Intensive Care Unit: A Case Series.

Guarracino Fabio F Forfori Francesco F Brizzi Giulia G Bertini Pietro P

A&A practice 20210521 5

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a highly infectious virus transmitted by inhalation of infected matter containing live virus or by exposure from contaminated surfaces. Aerosol-generating procedures (AGPs) create an increased risk of airborne transmission of infection. Tracheal extubation of coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU) is a risky AGP procedure owing to the proximity of the staff members to the patients' mouths and t ...[more]

PMID: 34018993

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Project description:BackgroundNoninvasive respiratory support (NIRS) has been diffusely employed outside the intensive care unit (ICU) to face the high request of ventilatory support due to the massive influx of patients with acute respiratory failure (ARF) caused by coronavirus-19 disease (COVID-19). We sought to summarize the evidence on clinically relevant outcomes in COVID-19 patients supported by NIV outside the ICU.MethodsWe searched PUBMED®, EMBASE®, and the Cochrane Controlled Clinical trials register, along with medRxiv and bioRxiv repositories for pre-prints, for observational studies and randomized controlled trials, from inception to the end of February 2021. Two authors independently selected the investigations according to the following criteria: (1) observational study or randomized clinical trials enrolling ≥ 50 hospitalized patients undergoing NIRS outside the ICU, (2) laboratory-confirmed COVID-19, and (3) at least the intra-hospital mortality reported. Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines were followed. Data extraction was independently performed by two authors to assess: investigation features, demographics and clinical characteristics, treatments employed, NIRS regulations, and clinical outcomes. Methodological index for nonrandomized studies tool was applied to determine the quality of the enrolled studies. The primary outcome was to assess the overall intra-hospital mortality of patients under NIRS outside the ICU. The secondary outcomes included the proportions intra-hospital mortalities of patients who underwent invasive mechanical ventilation following NIRS failure and of those with 'do-not-intubate' (DNI) orders.ResultsSeventeen investigations (14 peer-reviewed and 3 pre-prints) were included with a low risk of bias and a high heterogeneity, for a total of 3377 patients. The overall intra-hospital mortality of patients receiving NIRS outside the ICU was 36% [30-41%]. 26% [21-30%] of the patients failed NIRS and required intubation, with an intra-hospital mortality rising to 45% [36-54%]. 23% [15-32%] of the patients received DNI orders with an intra-hospital mortality of 72% [65-78%]. Oxygenation on admission was the main source of between-study heterogeneity.ConclusionsDuring COVID-19 outbreak, delivering NIRS outside the ICU revealed as a feasible strategy to cope with the massive demand of ventilatory assistance.RegistrationPROSPERO, https://www.crd.york.ac.uk/prospero/ , CRD42020224788, December 11, 2020.

Dataset Information

Preventing Severe Acute Respiratory Syndrome Coronavirus-2 Exhalation Upon Tracheal Extubation in the Intensive Care Unit: A Case Series.

Publications

Preventing Severe Acute Respiratory Syndrome Coronavirus-2 Exhalation Upon Tracheal Extubation in the Intensive Care Unit: A Case Series.

Similar Datasets

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