Evidence map›Paper›PMID 39661843›Full record

ArticleJornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia2024

CPAP delivered via a helmet interface in lightly sedated patients with moderate to severe ARDS: predictors of success outside the ICU.

Isabella de Melo Matos, Betina Santos Tomaz, Maria da Penha Uchoa Sales, Gabriela Carvalho Gomes, Antonio Brazil Viana Junior, Miguel R Gonçalves, Marcelo Alcantara Holanda, Eanes Delgado Barros Pereira

Abstract read
In one paragraph

Article in Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. ELMO-CPAP: an effective approach in the management of patients with acute hypoxemic respiratory failure.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2024
    Article
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

8 authors.

Isabella de Melo Matos. Departamento de Medicina Interna, Universidade Federal do Ceará, Fortaleza (CE) Brasil.ORCID 0009-0007-5891-2992
Betina Santos Tomaz. Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza (CE) Brasil.ORCID 0000-0002-2523-7296
Maria da Penha Uchoa Sales. Serviço de Pneumologia, Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza (CE) Brasil.ORCID 0000-0002-4226-6216
Gabriela Carvalho Gomes. Departamento de Medicina Interna, Universidade Federal do Ceará, Fortaleza (CE) Brasil.ORCID 0000-0002-9342-7737
Antonio Brazil Viana Junior. Centro de Pesquisa Clínica, Universidade Federal do Ceará, Fortaleza (CE) Brasil.ORCID 0000-0001-6608-3134
Miguel R Gonçalves. Unidade de Suporte de Ventilação Não Invasiva, Serviço de Pneumologia e de Emergência e Cuidado Intensivo, Centro Hospitalar de São João, Porto, Portugal.ORCID 0000-0001-7943-9507
Marcelo Alcantara Holanda. Departamento de Medicina Interna, Universidade Federal do Ceará, Fortaleza (CE) Brasil.ORCID 0000-0002-6002-0084
Eanes Delgado Barros Pereira. Departamento de Medicina Interna, Universidade Federal do Ceará, Fortaleza (CE) Brasil.ORCID 0000-0002-4414-3164

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to describe the outcomes and explore predictors of intubation and mortality in patients with ARDS due to COVID-19 treated with CPAP delivered via a helmet interface and light sedation.

methodsThis was a retrospective cohort study involving patients with COVID-19-related ARDS who received CPAP using a helmet developed in Brazil (ELMO™), associated with a light sedation protocol in a pulmonology ward. Demographic, clinical, imaging, and laboratory data, as well as the duration and response to the ELMO-CPAP sessions, were analyzed.

resultsThe sample comprised 180 patients. The intubation avoidance rate was 72.8%. The lack of necessity for intubation was positively correlated with younger age, > 24-h continuous HELMET-CPAP use in the first session, < 75% pulmonary involvement on CT, and ROX index > 4.88 in the second hour. The overall in-hospital mortality rate was 18.9%, whereas those in the nonintubated and intubated groups were 3.0% and 61.2%, respectively. Advanced age increased the mortality risk by 2.8 times, escalating to 13 times post-intubation.

conclusionsELMO-CPAP with light sedation in a pulmonology ward was successful in > 70% of patients with moderate to severe ARDS due to COVID-19. Younger age, pulmonary involvement, ROX index, and prolonged first Helmet-CPAP session duration were associated with no need for intubation. Older age and intubation are associated with mortality.

Indexed as

Continuous Positive Airway PressureCOVID-19Respiratory Distress SyndromeAdultAgedBrazilFemaleHead Protective DevicesHospital MortalityHumansIntensive Care UnitsIntubation, IntratrachealMaleMiddle AgedProcedural SedationRetrospective Studies

Identifiers

PMID39661843
PMCPMC11601069

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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.