Ventilatory therapies and Intensive Care admissions for patients with COVID-19: a systematic review

I. Morales-Cané, M. del Rocío Valverde-León, J. González-Gancedo, P.M. Rodríguez-Muñoz, P. Hidalgo-Lopezosa, M.A. Rodríguez-Borrego, P.J. López-Soto

Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Córdoba/Reina Sofia University Hospital, Córdoba, Spain. pablo.lopez@imibic.org

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• Infectious Diseases

OBJECTIVE: The aim of the study was to synthesize and analyze the scientific publications related to ventilatory therapies used in patients with COVID-19 in Intensive Care Units (ICUs), the parameters of invasive mechanical ventilation prescribed for these patients, and the clinical characteristics of patients admitted to the ICU.

MATERIALS AND METHODS: A systematic review was carried out through the PubMed, Embase, Web of Science and Cochrane Library databases. Studies published up to 31/05/2020 were included if they made reference to ventilatory therapies used in ICU patients with COVID-19.

RESULTS: Qualitative analysis was performed on 30 included studies. A total sample of 48,743 patients was analyzed, of which 17.66% were admitted to ICUs, and 6.4% of these patients died. Of the patients analyzed, 44.4% required some type of respiratory support. Specifically, 12.8% of patients received invasive mechanical ventilation, while 9.7% received non-invasive mechanical ventilation, and 29.7% received high-flow nasal oxygen.

CONCLUSIONS: COVID-19 has led to a high number of ICU admissions and a challenge for ICUs is to provide the best ventilatory therapy available to patients admitted. It has been observed that the available figures for ICU admissions and the use of ventilatory therapies are similar across continents. However, the data suggest that geographic areas with higher rates of ICU admission have lower mortality rates. The lack of information in some of the clinical records limits the ability to obtain more conclusive results.

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