Next :: Claude Guerin. Covid v non covid and NIV. #LIVES2022 #ventilation #NIV @ESICM summarising risk factors for NIV failure - old age, multi organ failure etc. then diving straight into “Happy Hypoxemia”.
Re-visiting H and L phenotypes. Silent or happy hypoxemia. So best to proceed by undertaking in depth literature search
But the evidence tends to suggest covid has higher mortality and is also v heterogeneous.
Contrasting with another classic lung safe study. Left graph non covid and right is covid. NIV group annotated. In comparison mortality is comparable at 40% and higher than with invasive.
Let’s look at “intubation”. NIV is tested here with high flow. No effect of NIV versus hfnc n covid and non covid to prevent intubation. NOTE. Significant heterogeneity. BUT. NIV better than SOR to prevent intubation
Just to note on mortality here .
But the new evidence not included in the meta analysis is HELMET NIV. In summary : rate of intubation is v similar between cov and non cov. NIC both cov or non covid prevented intubation without significant effect in mortality. So effectively :: NIV is NIV whatever the aetiology
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