Correlation of hypercapnia with outcome of NIV in critically ill patients with COVID-19

Abstract

The rapid global spread of the novel COVID-19 virus has led to a surge in cases of viral pneumonia and acute respiratory failure, necessitating respiratory support in affected patients. Initially, aggressive ventilation strategies were thought to be beneficial due to the unknown nature of the virus. However, emerging evidence has suggested that timely implementation of non-aggressive ventilation may lead to lower mortality rates compared to aggressive ventilation approaches. Despite this, many aspects related to non-invasive ventilation (NIV) in COVID-19 patients remain poorly understood, warranting further investigation. Therefore, this retrospective cross-sectional/descriptive study aims to explore the relationship between hypercapnia and prognosis in COVID-19 patients treated with NIV, with the goal of informing therapeutic management strategies. Method: A total of 200 COVID-19 patients receiving NIV will be retrospectively enrolled in the study from 1/21/2024 to 5/19/2022. Demographic data, vital signs, initial and peak biochemical values, arterial blood gas measurements, as well as data on disease outcomes, complications, and prognosis will be recorded for each patient. Subsequently, the relationship between hypercapnia and the recorded variables will be analyzed. Results: Analysis of arterial blood gases and oxygenation status revealed no significant difference in the PaO2/FiO2 ratio between the hypercapnic and normocapnic groups. However, the hypercapnic group exhibited significantly lower pH levels, consistent with higher PaCO2 levels. Hospital implications comparison revealed significantly longer durations of hospital and ICU stays, ventilation, and unsuccessful NIV in the hypercapnic group compared to the normocapnic group. Mortality rates did not significantly differ between the two groups.