NIV use in Covid-19 respiratory failure: A retrospective study
Research type
Research Study
Full title
Non-invasive ventilation in Covid-19 respiratory failure - predicting success: A retrospective observational study to determine predictive factors in the success or failure of non-invasive ventilation.
IRAS ID
298787
Contact name
Jamie Hooker
Contact email
Sponsor organisation
NHS Ayrshire and Arran
Duration of Study in the UK
0 years, 4 months, 1 days
Research summary
Summary of Research
Non-invasive ventilation (NIV) is increasingly being used for the management of Covid-19 respiratory failure, however it seems to demonstrate varying levels of success. The HACOR score is a tool developed to help predict NIV failure and the need for intubation (1). The HACOR score has not been validated for use in Covid-19 respiratory failure and this retrospective single-centre observational study aims to contribute to the evidence in this area. Furthermore, we hope to determine if there are any other predictive factors which exist indicating likely success of NIV.
Summary of Results
Non-invasive ventilation in Covid-19 respiratory failure - predicting success: A retrospective observational study to determine predictive factors in the success or failure of non-invasive ventilation. This study was carried out by a clinical team in NHS Ayrshire and Arran, and was sponsored by the NHS Ayrshire and Arran research and development department. It was a study carried out between August and November 2021 at University Hospital Crosshouse.
The research aimed to provide further information on the ability of a scoring system (the HACOR score) to accurately predict whether continuous positive airway pressure (CPAP) treatment would be of benefit to individual patients with COVID-19 disease. Other research has shown that CPAP treatment is of overall benefit in COVID-19 but identifying which patients will deteriorate (to intubation or death) despite it remains a challenge.
The authors looked at data from patients who had received CPAP for COVID-19 at University Hospital Crosshouse between March 2020 and April 2021 and applied the HACOR score to this data.
Seventy patients who received CPAP for COVID-19 during the review period were identified. The authors established that the HACOR score was most accurate at predicting whether CPAP would fail at 12 hours after its commencement. At this point, the HACOR score could predict CPAP failure with an accuracy of 77.4%. This result was statistically significant (demonstrated by a p-value of 0.005; this means there is only a 1 in 200 likelihood that the results we saw occurred 'by chance').
This study adds weight to a growing body of evidence that the HACOR score may be able to predict CPAP failure in COVID-19. Being able to predict patients who will, and who will not, benefit from CPAP has potential benefits for individual patients and healthcare systems.
REC name
West of Scotland REC 4
REC reference
21/WS/0091
Date of REC Opinion
11 Aug 2021
REC opinion
Favourable Opinion