Non-invasive ventilation in acute respiratory failure in patients with coronavirus infection at the pre-resuscitation stage

Introduction. The coronavirus epidemic, which began in 2019 and quickly spread throughout the world, was characterized by viral pneumonia and acute hypoxemic respiratory failure.

Aim. To evaluate the effectiveness of non-invasive ventilation in patients with acute respiratory failure due to coronavirus infection at the pre-intensive care unit stage.

Materials and methods. A retrospective cohort study included patients with confirmed coronavirus infection and acute respiratory failure. Demographic, clinical, and laboratory data were collected at admission, while respiratory parameters were recorded both before the initiation of noninvasive ventilation and during the first 24 hours of its application.

Results. For most patients, noninvasive ventilation was successful, but some required transfer to the intensive care unit due to its ineffectiveness. Overall mortality in the study group was significant. Patients for whom non-invasive ventilation was ineffective were older and had higher respiratory rates and levels of certain biochemical markers upon admission. А few hours after the initiation of noninvasive ventilation, these patients demonstrated higher minute ventilation and ventilatory ratio values. Factors identified as potential predictors of noninvasive ventilation failure included low oxygen saturation before ventilation, elevated ventilatory ratio, increased minute ventilation, and tidal volume several hours after the intervention began.

Conclusion. Thus, noninvasive ventilation can be an effective treatment for patients with acute hypoxemic respiratory failure caused by coronavirus infection at the pre-intensive care unit stage.

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