tetano
Editor, Senior Moderator
J Clin Med
. 2022 Mar 16;11(6):1636.
doi: 10.3390/jcm11061636.
Chest X-ray Does Not Predict the Risk of Endotracheal Intubation and Escalation of Treatment in COVID-19 Patients Requiring Noninvasive Respiratory Support
Tommaso Pettenuzzo[SUP] 1 [/SUP], Chiara Giraudo[SUP] 2 3 [/SUP], Giulia Fichera[SUP] 4 [/SUP], Michele Della Paolera[SUP] 3 [/SUP], Martina Tocco[SUP] 3 [/SUP], Michael Weber[SUP] 5 [/SUP], Davide Gorgi[SUP] 6 [/SUP], Silvia Carlucci[SUP] 6 [/SUP], Federico Lionello[SUP] 7 [/SUP], Sara Lococo[SUP] 7 [/SUP], Annalisa Boscolo[SUP] 1 [/SUP], Alessandro De Cassai[SUP] 1 [/SUP], Laura Pasin[SUP] 1 [/SUP], Marco Rossato[SUP] 3 6 [/SUP], Andrea Vianello[SUP] 7 [/SUP], Roberto Vettor[SUP] 3 6 [/SUP], Nicolò Sella[SUP] 1 3 [/SUP], Paolo Navalesi[SUP] 1 3 [/SUP]
Affiliations
Abstract
Forms of noninvasive respiratory support (NIRS) have been widely used to avoid endotracheal intubation in patients with coronavirus disease-19 (COVID-19). However, inappropriate prolongation of NIRS may delay endotracheal intubation and worsen patient outcomes. The aim of this retrospective study was to assess whether the CARE score, a chest X-ray score previously validated in COVID-19 patients, may predict the need for endotracheal intubation and escalation of respiratory support in COVID-19 patients requiring NIRS. From December 2020 to May 2021, we included 142 patients receiving NIRS who had a first chest X-ray available at NIRS initiation and a second one after 48-72 h. In 94 (66%) patients, the level of respiratory support was increased, while endotracheal intubation was required in 83 (58%) patients. The CARE score at NIRS initiation was not predictive of the need for endotracheal intubation (odds ratio (OR) 1.01, 95% confidence interval (CI) 0.96-1.06) or escalation of treatment (OR 1.01, 95% CI 0.96-1.07). In conclusion, chest X-ray severity, as assessed by the CARE score, did not allow predicting endotracheal intubation or escalation of respiratory support in COVID-19 patients undergoing NIRS.
Keywords: chest X-ray; coronavirus disease-19; endotracheal intubation; noninvasive respiratory support.
. 2022 Mar 16;11(6):1636.
doi: 10.3390/jcm11061636.
Chest X-ray Does Not Predict the Risk of Endotracheal Intubation and Escalation of Treatment in COVID-19 Patients Requiring Noninvasive Respiratory Support
Tommaso Pettenuzzo[SUP] 1 [/SUP], Chiara Giraudo[SUP] 2 3 [/SUP], Giulia Fichera[SUP] 4 [/SUP], Michele Della Paolera[SUP] 3 [/SUP], Martina Tocco[SUP] 3 [/SUP], Michael Weber[SUP] 5 [/SUP], Davide Gorgi[SUP] 6 [/SUP], Silvia Carlucci[SUP] 6 [/SUP], Federico Lionello[SUP] 7 [/SUP], Sara Lococo[SUP] 7 [/SUP], Annalisa Boscolo[SUP] 1 [/SUP], Alessandro De Cassai[SUP] 1 [/SUP], Laura Pasin[SUP] 1 [/SUP], Marco Rossato[SUP] 3 6 [/SUP], Andrea Vianello[SUP] 7 [/SUP], Roberto Vettor[SUP] 3 6 [/SUP], Nicolò Sella[SUP] 1 3 [/SUP], Paolo Navalesi[SUP] 1 3 [/SUP]
Affiliations
- PMID: 35329962
- DOI: 10.3390/jcm11061636
Abstract
Forms of noninvasive respiratory support (NIRS) have been widely used to avoid endotracheal intubation in patients with coronavirus disease-19 (COVID-19). However, inappropriate prolongation of NIRS may delay endotracheal intubation and worsen patient outcomes. The aim of this retrospective study was to assess whether the CARE score, a chest X-ray score previously validated in COVID-19 patients, may predict the need for endotracheal intubation and escalation of respiratory support in COVID-19 patients requiring NIRS. From December 2020 to May 2021, we included 142 patients receiving NIRS who had a first chest X-ray available at NIRS initiation and a second one after 48-72 h. In 94 (66%) patients, the level of respiratory support was increased, while endotracheal intubation was required in 83 (58%) patients. The CARE score at NIRS initiation was not predictive of the need for endotracheal intubation (odds ratio (OR) 1.01, 95% confidence interval (CI) 0.96-1.06) or escalation of treatment (OR 1.01, 95% CI 0.96-1.07). In conclusion, chest X-ray severity, as assessed by the CARE score, did not allow predicting endotracheal intubation or escalation of respiratory support in COVID-19 patients undergoing NIRS.
Keywords: chest X-ray; coronavirus disease-19; endotracheal intubation; noninvasive respiratory support.