VENTILATORY SUPPORT IN SARS-VOC-2 DURING INTENSIVE THERAPY

  1. Javier Eliecer Pereira Rodriguez
  2. Juan Camilo Quintero Gomez
  3. Otilio Lopez Florez
  4. Sandra Sharon Waiss Skvirsky
  5. Ximena Velasquez Badillo

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Abstract

Introduction: The SARS-CoV-2 disease outbreak has now become a pandemic. Critical patients with COVID-19 require basic and advanced respiratory support. Therefore, the objective was to describe the ventilatory support strategies in SARS-CoV-2 during intensive therapy. Materials and methods: A systematic review of observational studies of the available scientific literature was performed in accordance with the recommendations of the Cochrane collaboration and the criteria of the PRISMA Declaration. Results: Fifteen observational studies were included that gave a study population of 4,081 patients. Mechanical ventilation is the main respiratory support treatment for critically ill patients, which should be administered as soon as normal oxygenation cannot be maintained, and despite the fact that there is no current consensus on the parameters of mechanical ventilation, the evidence collected suggests the use of Fio2 on average 50%, PEEP of 14 cmH2O, lung compliance of 29-37 ml per cm of water, driving pressure between 12-14 cm of water and a plateau pressure of 22-25 cm of water. Conclusions: IL-6 is shown as a possible marker of respiratory failure and a worse prognosis as well as obesity. In addition, the use of prone position, neuromuscular blockade, pulmonary vasodilators, ECMO, and mechanical ventilation based on the clinical conditions and needs of the patient with COVID-19 are strategies that could benefit patients entering intensive therapy for SARS-CoV- 2.

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  1. ScreenIT

    SciScore for 10.1101/2020.05.14.20098608: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Research that included experimental studies with human beings had informed consent under the ethical considerations of Helsinki11, for the regulation of experimental studies in living beings.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The databases identified for searching scientific studies included: PubMed and PubMed Central.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Thus, the search strategy was as follows: (“respiration, artificial” [MeSH Terms] OR (
    MeSH
    suggested: (MeSH, RRID:SCR_004750)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    However, it should be noted that the limitations of this study refer to the limited scientific evidence on the use of mechanical ventilation in patients with SARS-CoV-2, however, different authors suggest, like this review, that the Invasive mechanical ventilation is associated with a worse prognosis and a higher percentage of mortality when not used correctly and with academic grounds. Similarly, the importance of very good early advanced ventilatory support is highlighted, since it can avoid the use of IMV in patients with COVID-1939-43.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.05.14.20098608v1 on medRxiv