التفاصيل البيبلوغرافية
| العنوان: |
Postextubation Stridor in Severe COVID-19. |
| المؤلفون: |
Abdallah, Georges Abi, Ferré, Alexis, Gros, Antoine, Simon, Christelle, Bruneel, Fabrice, Marque-Juillet, Stéphanie, Legriel, Stéphane, Paul, Marine |
| المصدر: |
Respiratory Care; Jun2022, Vol. 67 Issue 6, p638-646, 9p |
| مصطلحات موضوعية: |
RESPIRATORY distress syndrome treatment, COVID-19, SCIENTIFIC observation, CONFIDENCE intervals, INTUBATION, VIRAL load, CONTINUING education units, RETROSPECTIVE studies, ACQUISITION of data, FISHER exact test, MANN Whitney U Test, ARTIFICIAL respiration, EXTUBATION, RESPIRATORY organ sounds, SEX distribution, MEDICAL records, LARYNGEAL edema, DESCRIPTIVE statistics, ODDS ratio, LYING down position |
| مصطلحات جغرافية: |
FRANCE |
| مستخلص: |
BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, 60-80% of patients admitted to ICU require mechanical ventilation for respiratory distress. We aimed to compare the frequency of postextubation stridor (PES) and to explore risk factors in COVID-19 subjects compared to those without COVID-19. METHODS: We performed an observational retrospective study on subjects admitted for severe COVID-19 requiring mechanical ventilation > 48 h during the first and second waves in 2020 and compared these subjects to historical controls without COVID-19 who received mechanical ventilation > 48 h between 2016-2019. The primary outcome was the frequency of PES, defined as audible stridor within 2 h following extubation. RESULTS: Of the 134 subjects admitted with severe COVID-19 requiring mechanical ventilation, 96 were extubated and included and compared to 211 controls. The frequency of PES was 22.9% in the COVID-19 subjects and 3.8%in the controls (P < .001). Factors independently associated with PES were having COVID-19 (odds ratio 3.72, [95% CI 1.24-12.14], P = .02), female sex (odds ratio 5.77 [95% CI 2.30-15.64], P < .001), and tube mobilization or re-intubation or prone positioning (odds ratio 3.01 [95% CI 1.04-9.44], P = .047) after adjustment on Simplified Acute Physiology Score II expanded). During the first wave, PES was significantly more common in subjects with a positive SARS-CoV-2 RT-PCR test on tracheal samples on the day of extubation (73.3% vs 24.3%, P = .018). CONCLUSIONS: PES affected nearly one-quarter of subjects with COVID-19, a proportion significantly higher than that seen in controls. Independent risk factors for PES were COVID-19, female sex, and tube mobilization or re-intubation or prone positioning. PES was associated with persistent viral shedding at the time of extubation. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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