Non-Invasive Ventilation versus Invasive Mechanical Ventilation: Results from a Tertiary Care Hospital
Muahmmad Rauf-ul-Hassan, Ahtesham Iqbal, Muhammad Waseem, Muhammad Zubair Ashraf, Tehreem Abaid, Anam Saleem
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ABSTRACT
Objective: To
compare the patient outcome in severe COVID-19 pneumonia between the
non-invasive ventilation and invasive mechanical ventilation.
Study design: Prospective, observational
study
Study Setting and Duration:
Department
of Pulmonology, Bahawal Victoria Hospital, Bahawalpur from January 2021 to June
2021.
Methodology: We analyzed 660 patients of
severe covid pneumonia. Conscious proning was done in those requiring ≥ 21 L
oxygen and oxygen saturation < 90%. We defined typical ARDS according to
Berlin criteria. Atypical ARDS did not fulfill set criteria. We divided ARDS
into 2 types i-e H and L type. We managed ARDS with either NIV, invasive
mechanical ventilation or both. We used multiple regression analysis to predict
ICU stay.
Results: Out of 660 patients, 285
(43.18%) developed biPAP failure and were subsequently intubated. We observed
273 (41.4%) overall mortality, 175 (64.1%) in IMV and 98 (35.9%) in the NIV
group (p<0.0001). invasive mechanical ventilation had statistically
significant correlation with mortality and also predicted ICU stay. (p=<
0.001, OR 3.2, p=0.001).
Conclusion: NIV therapy is superior to
invasive mechanical ventilation in terms of ICU stay and outcome.
Keywords: ARDS, coronavirus,
COVID-19, non-invasive ventilation, mechanical ventilation, pneumonia