Evidence map›Paper›PMID 37349238›Full record

ArticleBritish journal of anaesthesia2023

Use of protracted CPAP as supportive treatment for COVID-19 pneumonitis and associated outcomes: a national cohort study.

Kathryn A Puxty, Michael Blayney, Callum Kaye, Joanne McPeake, Neil Stewart, Martin Paton, Ros Hall, Lorraine Donaldson, Nazir Lone

Open access · hybridAbstract read
In one paragraph

Article in British journal of anaesthesia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.3field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 2 countries.

Kathryn A PuxtyDepartment of Critical Care, NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, Glasgow, UK; School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK. Electronic address: kathryn.puxty@glasgow.ac.uk.
Michael BlayneyUsher Institute, University of Edinburgh, Edinburgh, UK.
Callum KayeDepartment of Critical Care, NHS Grampian, Aberdeen Royal Infirmary, Aberdeen, UK.
Joanne McPeakeHealthcare Improvement Scotland (Improvement Hub), Glasgow, UK; The Institute of Healthcare Improvement Studies, University of Cambridge, Cambridge, UK.
Neil StewartDepartment of Critical Care, NHS Forth Valley, Forth Valley Royal Hospital, Larbert, UK.
Martin PatonPublic Health Scotland, UK.
Ros HallPublic Health Scotland, UK.
Lorraine DonaldsonPublic Health Scotland, UK.
Nazir LoneUsher Institute, University of Edinburgh, Edinburgh, UK; Department of Critical Care, NHS Lothian, Edinburgh Royal Infirmary, UK.
Public Health Scotland · GBAberdeen Royal Infirmary · GBForth Valley Royal Hospital · GBNHS Greater Glasgow and Clyde · GBNHS Lothian · GBUniversity of Cambridge · GBUniversity of Edinburgh · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundContinuous positive airway pressure (CPAP) has been increasingly deployed to manage patients with COVID-19 and acute respiratory failure, often for protracted periods. However, concerns about protracted CPAP have been raised. This study aimed to examine the use of CPAP for patients with COVID-19 and the outcomes after protracted use.

methodsThis was a national cohort study of all adults admitted to Scottish critical care units with COVID-19 from March 1, 2020 to December 25, 2021 who received CPAP. Protracted CPAP was defined as ≥ 5 continuous days of CPAP. Outcomes included CPAP failure rate (institution of invasive mechanical ventilation [IMV] or death), mortality, and outcomes after institution of IMV. Multivariable logistic regression was performed to assess the impact of protracted CPAP on mortality after IMV.

resultsA total of 1961 patients with COVID-19 received CPAP for COVID-19 pneumonitis, with 733 patients (37.4%) receiving protracted CPAP. CPAP failure occurred in 891 (45.4%): 544 patients (27.7%) received IMV and 347 patients (17.7%) died in critical care without IMV. Hospital mortality rate was 41.3% for the population. For patients who subsequently commenced IMV, hospital mortality was 58.7% for the standard duration CPAP group and 73.9% for the protracted duration CPAP group (P=0.003); however, there was no statistical difference in hospital mortality after adjustment for confounders (odds ratio 1.4, 95% confidence interval 0.84-2.33, P=0.195).

conclusionsProtracted CPAP was used frequently for managing patients with COVID-19. Whilst it was not associated with worse outcomes for those patients who subsequently required IMV, this might be due to residual confounding and differences in processes of care.

Indexed as

Continuous Positive Airway PressureCOVID-19PneumoniaAdultCohort StudiesHumansNoninvasive VentilationRespiration, ArtificialARDScontinuous positive airway pressureCOVID-19CPAPnoninvasive ventilationpneumonitis

Identifiers

PMID37349238
PMCPMC10209449
OpenAlexW4378191345

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.