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Multidisciplinary approach of the sequelae one month after hospital discharge in patients with severe bilateral COVID-19 pneumonia, are there differences depending on the respiratory therapy used during admission to intensive care? Med Intensiva 2022; 47:257-266. [PMID: 36621347 PMCID: PMC9760609 DOI: 10.1016/j.medine.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To describe the sequelae one month after hospital discharge in patients who required admission to Intensive Care for severe COVID 19 pneumonia and to analyze the differences between those who received therapy exclusively with high-flow oxygen therapy compared to those who required invasive mechanical ventilation. DESIGN Cohort, prospective and observational study. SETTING Post-intensive care multidisciplinary program. PATIENTS OR PARTICIPANTS Patients who survived admission to the intensive care unit (ICU) for severe COVID 19 pneumonia from April 2020 to October 2021. INTERVENTIONS Inclusion in the post-ICU multidisciplinary program. MAIN VARIABLES OF INTEREST Motor, sensory, psychological/psychiatric, respiratory and nutritional sequelae after hospital admission. RESULTS 104 patients were included. 48 patients received high-flow nasal oxygen therapy (ONAF) and 56 invasive mechanical ventilation (IMV). The main sequelae found were distal neuropathy (33.9% IMV vs 10.4% ONAF); brachial plexopathy (10.7% IMV vs 0% ONAF); decrease in grip strength: right hand 20.67kg (±8.27) in VMI vs 31.8kg (±11.59) in ONAF and left hand 19.39kg (±8.45) in VMI vs 30.26kg (±12.74) in ONAF; and limited muscle balance in the lower limbs (28.6% VMI vs 8.6% ONAF). The differences observed between both groups did not reach statistical significance in the multivariable study. CONCLUSIONS The results obtained after the multivariate study suggest that there are no differences in the perceived physical sequelae one month after hospital discharge depending on the respiratory therapy used, whether it was high-flow nasal oxygen therapy or prolonged mechanical ventilation, although more studies are needed to be able to draw conclusions.
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Sánchez-García AM, Martínez-López P, Gómez-González AM, Rodriguez-Capitán J, Jiménez-López RJ, García Almeida JM, Avanesi-Molina E, Zamboschi N, Rueda-Molina C, Doncel-Abad V, Molina-Ramos AI, Cabrera-César E, Ben-Abdellatif I, Gordillo-Resina M, Pérez-Mesa E, Nieto-González M, Nuevo-Ortega P, Reina-Artacho C, Sánchez Fernández PL, Jiménez-Navarro MF, Estecha-Foncea MA. ["Multidisciplinary Approach of the sequelae one month after hospital discharge in patients with severe bilateral COVID-19 pneumonia, are there differences depending on the respiratory therapy used during admission to Intensive Care?"]. Med Intensiva 2022; 47:257-266. [PMID: 36506823 PMCID: PMC9721276 DOI: 10.1016/j.medin.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To describe the sequelae one month after hospital discharge in patients who required admission to Intensive Care for severe COVID 19 pneumonia and to analyze the differences between those who received therapy exclusively with high-flow oxygen therapy compared to those who required invasive mechanical ventilation. DESIGN Cohort, prospective and observational study. SETTING Post-intensive care multidisciplinary programPatients or participants: Patients who survived admission to the intensive care unit (ICU) for severe COVID 19 pneumonia from April 2020 to October 2021Interventions: Inclusion in the post-ICU multidisciplinary programMain variables of interest: Motor, sensory, psychological/psychiatric, respiratory and nutritional sequelae after hospital admissionResults. 104 patients were included. 48 patients received high-flow nasal oxygen therapy (ONAF) and 56 invasive mechanical ventilation (IMV). The main sequelae found were distal neuropathy (33.9% IMV vs 10.4% ONAF); brachial plexopathy (10.7% IMV vs 0% ONAF); decrease in grip strength: right hand 20.67kg (+/- 8.27) in VMI vs 31.8kg (+/- 11.59) in ONAF and left hand 19.39kg (+/- 8.45) in VMI vs 30.26kg (+/- 12.74) in ONAF; and limited muscle balance in the lower limbs (28.6% VMI vs 8.6% ONAF). The differences observed between both groups did not reach statistical significance in the multivariable study. CONCLUSIONS The results obtained after the multivariate study suggest that there are no differences in the perceived physical sequelae one month after hospital discharge depending on the respiratory therapy used, whether it was high-flow nasal oxygen therapy or prolonged mechanical ventilation, although more studies are needed to be able to draw conclusions.
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Affiliation(s)
- A M Sánchez-García
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Intensiva, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - P Martínez-López
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Intensiva, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - A M Gómez-González
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Física y Rehabilitación, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - J Rodriguez-Capitán
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, España
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - R J Jiménez-López
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Familiar y Comunitaria, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - J M García Almeida
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - E Avanesi-Molina
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Salud Mental, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - N Zamboschi
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Intensiva, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - C Rueda-Molina
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Intensiva, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - V Doncel-Abad
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, España
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - A I Molina-Ramos
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, España
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - E Cabrera-César
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Neumología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - I Ben-Abdellatif
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Intensiva, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - M Gordillo-Resina
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Intensiva, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - E Pérez-Mesa
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Intensiva, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - M Nieto-González
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Intensiva, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - P Nuevo-Ortega
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Intensiva, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - C Reina-Artacho
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Intensiva, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - P L Sánchez Fernández
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, España
- Servicio de Cardiología. Hospital Universitario de Salamanca-IBSAL. Universidad de Salamanca, Salamanca, España
| | - M F Jiménez-Navarro
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, España
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - M A Estecha-Foncea
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, España
- Servicio de Medicina Intensiva, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
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González-Castro A, Medina A, Modesto I Alapont V, Cuenca-Fito E, Fernandez-Rodríguez A, Peñasco Y. The need for rigorous analysis of the effectiveness and efficiency of high flow oxygen therapy during the SARS-CoV-2 pandemic. Med Intensiva 2021; 45:S0210-5691(21)00028-0. [PMID: 33781625 PMCID: PMC7938731 DOI: 10.1016/j.medin.2021.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 02/22/2021] [Accepted: 02/27/2021] [Indexed: 11/20/2022]
Affiliation(s)
- A González-Castro
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España.
| | - A Medina
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Asturias, España
| | - V Modesto I Alapont
- Médico experto en Epidemiología, Medicina de Urgencias y Medicina Respiratoria, Chief of PICU at Hospital La Fe, Valencia, España
| | - E Cuenca-Fito
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - A Fernandez-Rodríguez
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - Y Peñasco
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España
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Godoy DA, Graneros N, Oyarzabal L, Murillo-Cabezas F. High-flow oxygen therapy in acute hypoxemic respiratory failure secondary to COVID-19 pneumonia. Med Intensiva 2021; 45:S0210-5691(21)00019-X. [PMID: 33707033 PMCID: PMC7891069 DOI: 10.1016/j.medin.2021.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 02/07/2021] [Indexed: 11/23/2022]
Affiliation(s)
- D A Godoy
- Unidad de Cuidados Neurointensivos, Sanatorio Pasteur, Catamarca, Argentina; Unidad de Terapia Intensiva, Hospital Carlos G. Malbran, Catamarca, Argentina.
| | - N Graneros
- Unidad de Terapia Intensiva, Hospital Carlos G. Malbran, Catamarca, Argentina
| | - L Oyarzabal
- Unidad de Terapia Intensiva, Hospital Carlos G. Malbran, Catamarca, Argentina
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