Chest X-ray Does Not Predict the Risk of Endotracheal Intubation and Escalation of Treatment in COVID-19 Patients Requiring Noninvasive Respiratory Support

Overview

Journal J Clin Med

Specialty General Medicine

Date 2022 Mar 25

PMID 35329962

Authors

Tommaso Pettenuzzo

Chiara Giraudo

Giulia Fichera

Michele Della Paolera

Martina Tocco

Michael Weber

Davide Gorgi

Silvia Carlucci

Federico Lionello

Sara Lococo

Annalisa Boscolo

Alessandro De Cassai

Laura Pasin

Marco Rossato

Andrea Vianello

Roberto Vettor

Nicolo Sella

Paolo Navalesi

Affiliations

Soon will be listed here.

Abstract

Forms of noninvasive respiratory support (NIRS) have been widely used to avoid endotracheal intubation in patients with coronavirus disease-19 (COVID-19). However, inappropriate prolongation of NIRS may delay endotracheal intubation and worsen patient outcomes. The aim of this retrospective study was to assess whether the CARE score, a chest X-ray score previously validated in COVID-19 patients, may predict the need for endotracheal intubation and escalation of respiratory support in COVID-19 patients requiring NIRS. From December 2020 to May 2021, we included 142 patients receiving NIRS who had a first chest X-ray available at NIRS initiation and a second one after 48-72 h. In 94 (66%) patients, the level of respiratory support was increased, while endotracheal intubation was required in 83 (58%) patients. The CARE score at NIRS initiation was not predictive of the need for endotracheal intubation (odds ratio (OR) 1.01, 95% confidence interval (CI) 0.96-1.06) or escalation of treatment (OR 1.01, 95% CI 0.96-1.07). In conclusion, chest X-ray severity, as assessed by the CARE score, did not allow predicting endotracheal intubation or escalation of respiratory support in COVID-19 patients undergoing NIRS.

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