학술논문
The use of oxygen hoods in patients failing on conventional high-flow oxygen delivery systems, the effects on oxygenation, mechanical ventilation and mortality rates in hypoxic patients with COVID-19. A Prospective Controlled Cohort Study.
Document Type
Academic Journal
Author
Dayya D; Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital - Northwell Health, Sleepy Hollow, NY, USA; Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, Upstate Medical University, State University of NY, Syracuse, NY, USA; Department of Internal Medicine, Department of Family Medicine, Division of Biostatistics, Department of Pathology, New York Medical College, Valhalla, NY, USA; Department of Family Medicine, University of Vermont, Larner College of Medicine, Burlington, VT, USA. Electronic address: ddayya1@northwell.edu.; O'Neill OJ; Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital - Northwell Health, Sleepy Hollow, NY, USA; Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, Upstate Medical University, State University of NY, Syracuse, NY, USA; Department of Internal Medicine, Department of Family Medicine, Division of Biostatistics, Department of Pathology, New York Medical College, Valhalla, NY, USA. Electronic address: ooneill@northwell.edu.; Feiertag TD; Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital - Northwell Health, Sleepy Hollow, NY, USA; Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, Upstate Medical University, State University of NY, Syracuse, NY, USA. Electronic address: ftracy@northwell.edu.; Tuazon-Boer R; Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital - Northwell Health, Sleepy Hollow, NY, USA; Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, Upstate Medical University, State University of NY, Syracuse, NY, USA. Electronic address: rtuazonboe@northwell.edu.; Sullivan J; Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital - Northwell Health, Sleepy Hollow, NY, USA; Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, Upstate Medical University, State University of NY, Syracuse, NY, USA. Electronic address: jsullivan14@northwell.edu.; Perez L; Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital - Northwell Health, Sleepy Hollow, NY, USA; Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, Upstate Medical University, State University of NY, Syracuse, NY, USA. Electronic address: lperez12@northwell.edu.; Gurash S; Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital - Northwell Health, Sleepy Hollow, NY, USA; Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, Upstate Medical University, State University of NY, Syracuse, NY, USA. Electronic address: sgurash@northwell.edu.; Eaton M; Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital - Northwell Health, Sleepy Hollow, NY, USA; Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, Upstate Medical University, State University of NY, Syracuse, NY, USA. Electronic address: meaton2@northwell.edu.; Bodley T; Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital - Northwell Health, Sleepy Hollow, NY, USA; Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, Upstate Medical University, State University of NY, Syracuse, NY, USA. Electronic address: tbodley@northwell.edu.; Marker J; Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital - Northwell Health, Sleepy Hollow, NY, USA; Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, Upstate Medical University, State University of NY, Syracuse, NY, USA. Electronic address: jmarker2@northwell.edu.; Smykowski E; Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital - Northwell Health, Sleepy Hollow, NY, USA; Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, Upstate Medical University, State University of NY, Syracuse, NY, USA. Electronic address: esmykowski@northwell.edu.; Hall T; Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital - Northwell Health, Sleepy Hollow, NY, USA; Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, Upstate Medical University, State University of NY, Syracuse, NY, USA. Electronic address: thall@northwell.edu.
Source
Publisher: Elsevier Country of Publication: England NLM ID: 8908438 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-3064 (Electronic) Linking ISSN: 09546111 NLM ISO Abbreviation: Respir Med Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Efforts to meet increased oxygen demands in COVID-19 patients are a priority in averting mechanical ventilation (MV), associated with high mortality approaching 76.4-97.2%. Novel methods of oxygen delivery could mitigate that risk. Oxygen hoods/helmets may improve: O 2 -saturation (SaO2), reduce in-hospital mechanical ventilation and mortality rates, and reduce length of hospitalization in hypoxic Covid-19 patients failing on conventional high-flow oxygen delivery systems.
Methods: DesignProspective Controlled Cohort Study. SettingSingle Center. ParticipantsAll patients admitted with a diagnosis of COVID-19 were reviewed and 136/347 patients met inclusion criteria. Study period3/6/2020 to 5/1/2020. 136 participants completed the study with known status for all outcome measures. Intervention or exposureOxygen hoods/helmets as compared to conventional high-flow oxygen delivery systems.
Main Outcome(s) and Measure(s): 1) Pre and post change in oxygen saturation (SaO2 ). 2) In-hospital Mechanical Ventilation (MV). 3) In-hospital Mortality. 4) Length of hospitalization.
Results: 136 patients including 58-intervention and 78-control patients were studied. Age, gender, and other demographics/prognostic indicators were comparable between cohorts. Oxygen hoods averted imminent or immediate intubation/MV in all 58 COVID-19 patients failing on conventional high-flow oxygen delivery systems with a mean improvement in SaO2 of 8.8%, p < 0.001. MV rates were observed to be higher in the control 37/78 (47.4%) as compared to the intervention cohort 23/58 (39.7%), a difference of 7.7%, a 27% risk reduction, not statistically significant, OR 95%CI 0.73 (0.37-1.5). Mortality rates were observed higher in the control 54/78 (69.2%) as compared to the intervention cohort 36/58 (62.1%), a difference of 7.1%, a 27% risk reduction, not statistically significant OR 95%CI 0.73 (0.36-1.5).
Conclusion: Oxygen hoods demonstrate improvement in SaO2 for patients failing on conventional high-flow oxygen-delivery systems and prevented imminent mechanical ventilation. In-hospital mechanical ventilation and mortality rates were reduced with the use of oxygen hoods but not found to be statistically significant. The oxygen hood is a safe, effective oxygen-delivery system which may reduce intubation/MV and mortality rates. Their use should be considered in treating hypoxic COVID-19 patients. Further research is warranted.
Trial Registration: ClinicalTrials.gov Identifier: NCT04407260.
(Copyright © 2021. Published by Elsevier Ltd.)
Methods: DesignProspective Controlled Cohort Study. SettingSingle Center. ParticipantsAll patients admitted with a diagnosis of COVID-19 were reviewed and 136/347 patients met inclusion criteria. Study period3/6/2020 to 5/1/2020. 136 participants completed the study with known status for all outcome measures. Intervention or exposureOxygen hoods/helmets as compared to conventional high-flow oxygen delivery systems.
Main Outcome(s) and Measure(s): 1) Pre and post change in oxygen saturation (SaO
Results: 136 patients including 58-intervention and 78-control patients were studied. Age, gender, and other demographics/prognostic indicators were comparable between cohorts. Oxygen hoods averted imminent or immediate intubation/MV in all 58 COVID-19 patients failing on conventional high-flow oxygen delivery systems with a mean improvement in SaO
Conclusion: Oxygen hoods demonstrate improvement in SaO
Trial Registration: ClinicalTrials.gov Identifier: NCT04407260.
(Copyright © 2021. Published by Elsevier Ltd.)