Respiratory supports of COVID-19 patients in intensive care unit: A systematic review
Introduction: We aimed to describe the respiratory supports and determine their association with clinical outcomes of COVID-19 patients in intensive care unit (ICU). Methods: A systemic literature search was conducted in PubMed, EMBASE, MedRxiv and BioRxiv database from December 2019 to 2 July 2020....
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| Format: | Article |
| Language: | English |
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Elsevier
2021-04-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844021009166 |
| _version_ | 1818643217859477504 |
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| author | Lichen Ouyang Muqing Yu Yan Zhu Jie Gong |
| author_facet | Lichen Ouyang Muqing Yu Yan Zhu Jie Gong |
| author_sort | Lichen Ouyang |
| collection | DOAJ |
| description | Introduction: We aimed to describe the respiratory supports and determine their association with clinical outcomes of COVID-19 patients in intensive care unit (ICU). Methods: A systemic literature search was conducted in PubMed, EMBASE, MedRxiv and BioRxiv database from December 2019 to 2 July 2020. Studies reporting the application of respiratory supports in COVID-19 patients admitted to ICU were included. Results: Forty studies with 15320 COVID-19 patients were included in this systematic review. The proportion of invasive mechanical ventilation (IMV) application in ICU patients with COVID-19 was 73.8%. Further analysis elucidated that the use rate of IMV in Asia, Europe and North America was 47%, 76.2% and 80.2%, respectively. The proportion of patients treated with prone positioning and IMV was 29.4%. 25.5% of COVID-19 patients requiring IMV developed ventilator-associated pneumonia. The mortality of patients treated with IMV was 51.1%, while only 17.5% of critically ill COVID-19 patients treated with non-IMV respiratory support died. Additionally, the utilization rate of IMV in non-survival patients was shown 17.26-folds (95%CI 2.89–103.24, p = 0.002) higher than that in survival patients, while the use rate of ECMO was no significant difference. Conclusions: Our findings highlight respiratory supports of COVID-19 patients admitted to ICU in different continents. IMV is a life-saving strategy for critically ill COVID-19 patients with ARDS, yet the mortality remains very high. |
| first_indexed | 2024-12-16T23:55:27Z |
| format | Article |
| id | doaj.art-6d36ed7ddbe14d6990a69d98e9251aa1 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-12-16T23:55:27Z |
| publishDate | 2021-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-6d36ed7ddbe14d6990a69d98e9251aa12022-12-21T22:11:13ZengElsevierHeliyon2405-84402021-04-0174e06813Respiratory supports of COVID-19 patients in intensive care unit: A systematic reviewLichen Ouyang0Muqing Yu1Yan Zhu2Jie Gong3Department of Immunology, School of Medicine, Jianghan University, Wuhan, China; Corresponding author.Department of Respiratory and Critical Care Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaReproductive Medicine Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; The First Clinical College, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Corresponding author.Introduction: We aimed to describe the respiratory supports and determine their association with clinical outcomes of COVID-19 patients in intensive care unit (ICU). Methods: A systemic literature search was conducted in PubMed, EMBASE, MedRxiv and BioRxiv database from December 2019 to 2 July 2020. Studies reporting the application of respiratory supports in COVID-19 patients admitted to ICU were included. Results: Forty studies with 15320 COVID-19 patients were included in this systematic review. The proportion of invasive mechanical ventilation (IMV) application in ICU patients with COVID-19 was 73.8%. Further analysis elucidated that the use rate of IMV in Asia, Europe and North America was 47%, 76.2% and 80.2%, respectively. The proportion of patients treated with prone positioning and IMV was 29.4%. 25.5% of COVID-19 patients requiring IMV developed ventilator-associated pneumonia. The mortality of patients treated with IMV was 51.1%, while only 17.5% of critically ill COVID-19 patients treated with non-IMV respiratory support died. Additionally, the utilization rate of IMV in non-survival patients was shown 17.26-folds (95%CI 2.89–103.24, p = 0.002) higher than that in survival patients, while the use rate of ECMO was no significant difference. Conclusions: Our findings highlight respiratory supports of COVID-19 patients admitted to ICU in different continents. IMV is a life-saving strategy for critically ill COVID-19 patients with ARDS, yet the mortality remains very high.http://www.sciencedirect.com/science/article/pii/S2405844021009166COVID-19Invasive mechanical ventilationProne positioning ventilationMortalityIntensive care unit |
| spellingShingle | Lichen Ouyang Muqing Yu Yan Zhu Jie Gong Respiratory supports of COVID-19 patients in intensive care unit: A systematic review Heliyon COVID-19 Invasive mechanical ventilation Prone positioning ventilation Mortality Intensive care unit |
| title | Respiratory supports of COVID-19 patients in intensive care unit: A systematic review |
| title_full | Respiratory supports of COVID-19 patients in intensive care unit: A systematic review |
| title_fullStr | Respiratory supports of COVID-19 patients in intensive care unit: A systematic review |
| title_full_unstemmed | Respiratory supports of COVID-19 patients in intensive care unit: A systematic review |
| title_short | Respiratory supports of COVID-19 patients in intensive care unit: A systematic review |
| title_sort | respiratory supports of covid 19 patients in intensive care unit a systematic review |
| topic | COVID-19 Invasive mechanical ventilation Prone positioning ventilation Mortality Intensive care unit |
| url | http://www.sciencedirect.com/science/article/pii/S2405844021009166 |
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