Nutritional Advice El Mondo
Objectives:
Although several international guidelines recommend early over late intubation of patients with severe coronavirus disease 2019 (COVID-19), this issue is still controversial. Therefore, this review article has been conducted.
What is the effect (if any) of timing of intubation on clinical outcomes of critically ill patients with COVID-19?
Study design:
This review article included 12 non-randomized cohort studies, involving 8,944 critically ill patients with COVID-19 (7639 early and 1305 late).
Results and conclusions:
The investigators found there was no statistically detectable difference on all-cause mortality between patients undergoing early versus late intubation [3981 deaths, 45.4% versus 39.1%, RR = 1.07, 95% CI = 0.99 to 1.15, p = 0.08].
This was also the case for duration of mechanical ventilation (MV) [1892 patients, MD = - 0.58 days, 95% CI = - 3.06 to 1.89 days, p = 0.65].
The investigators found in a sensitivity analysis using an alternate definition of early/late intubation, intubation without versus with a prior trial of high-flow nasal cannula or noninvasive mechanical ventilation was still not associated with a statistically detectable difference on all-cause mortality [1128 deaths, 48.9% versus 42.5%, RR = 1.11, 95% CI = 0.99 to 1.25, p = 0.08].
The investigators concluded that timing of intubation has no effect on mortality and morbidity of critically ill patients with COVID-19. These results might justify a wait-and-see approach, which may lead to fewer intubations. Relevant guidelines may therefore need to be updated.
Original title:
Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies by Papoutsi E, Giannakoulis VG, […], Siempos LL.
Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7993905/
Additional information of El Mondo:
Find more information/studies on coronavirus right here.
Intubation is the process of inserting a tube, called an endotracheal tube (ET), through the mouth and then into the airway.