Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Failure of Non-invasive Respiratory Support in Patients with SARS-Cov-2 with the Different Therapies

Juan Javier García-Fernández
ORCID logo ,
José Andrés Sánchez-Nicolás
* ,
Sonia Galicia-Puyol
,
Isabel Gil-Rosa
,
Juan Jose Guerras Conesa
,
Enrique Bernal-Morell
,
César Cinesi-Gómez
Version 1 : Received: 28 September 2023 / Approved: 29 September 2023 / Online: 29 September 2023 (10:41:45 CEST)

A peer-reviewed article of this Preprint also exists.

García-Fernández, J.J.; Sánchez-Nicolás, J.A.; Galicia-Puyol, S.; Gil-Rosa, I.; Guerras-Conesa, J.J.; Bernal-Morell, E.; Cinesi-Gómez, C. Failure of Non-Invasive Respiratory Support in Patients with SARS-CoV-2. J. Clin. Med. 2023, 12, 6537. García-Fernández, J.J.; Sánchez-Nicolás, J.A.; Galicia-Puyol, S.; Gil-Rosa, I.; Guerras-Conesa, J.J.; Bernal-Morell, E.; Cinesi-Gómez, C. Failure of Non-Invasive Respiratory Support in Patients with SARS-CoV-2. J. Clin. Med. 2023, 12, 6537.

Abstract

Introduction: The objective of the study is to assess the failure of therapies with HFNO (High-Flow Nasal Oxygen), CPAP, Bilevel or combined therapy in patients with hypoxemic acute respiratory failure due to SARS-CoV-2 during their hospitalization. Methods: Retrospective and observational study of SARS-CoV-2 positive patients who required non-invasive respiratory support (NIRS), at the Reina Sofía General University Hospital of Murcia between March 2020 and May 2021. Results: Of 7355 patients, 197 (11,8%) were included. 95 of them failed this therapy (48,3%). We objectivated that during hospitalization in the ward the combined therapy with HFNO and CPAP had a lower failure rate overall and the highest treatment purely with Bilevel (p = 0,005). In the comparison of failure in therapy without two levels of airway pressure, HFNO, CPAP and combined therapy of HFNO with CPAP, (35,6% of patients) presented a 24,2% failure compared to those who did have two levels of pressure with Bilevel and combined therapy of HFNO with Bilevel (64,4% of patients) with 75,8% associated failure (OR: 0, 374; CI 95%: 0,203-0,688. p=0,001).Conclusions: The use of NIRS in conventional hospitalization is safe and effective in patients with respiratory failure secondary to SARS-CoV-2 infection. The therapeutic strategy with Bilevel increases the probability of failure, with the combined therapy strategy with CPAP and HFNO being the most promising option.

Keywords

Non-invasive respiratory support 1; SARS-CoV-2 2; Hospitalization 3; CPAP 4; HFNO 5; Bilevel 6

Subject

Medicine and Pharmacology, Internal Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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