Academic Journal
Management of pregnant women in tertiary maternity hospitals in the Paris area referred to the intensive care unit for acute hypoxaemic respiratory failure related to SARS-CoV-2: which practices for which outcomes?
| العنوان: | Management of pregnant women in tertiary maternity hospitals in the Paris area referred to the intensive care unit for acute hypoxaemic respiratory failure related to SARS-CoV-2: which practices for which outcomes? |
|---|---|
| المؤلفون: | Schortgen, Frédérique, Tabra Osorio, Cécilia, Demiri, Suela, Dzogang, Cleo, Jung, Camille, Lavenu, Audrey, Lecarpentier, Edouard |
| المساهمون: | Centre Hospitalier Intercommunal de Créteil (CHIC), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut de Recherche Mathématique de Rennes (IRMAR), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-École normale supérieure - Rennes (ENS Rennes)-Université de Rennes 2 (UR2)-Centre National de la Recherche Scientifique (CNRS)-Institut Agro Rennes Angers, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Centre d'Investigation Clinique Rennes (CIC), Université de Rennes (UR)-Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Pontchaillou -Institut National de la Santé et de la Recherche Médicale (INSERM), None |
| المصدر: | ISSN: 2110-5820 ; Annals of Intensive Care ; https://hal.science/hal-04650991 ; Annals of Intensive Care, 2024, 14 (1), pp.94. ⟨10.1186/s13613-024-01313-2⟩. |
| بيانات النشر: | HAL CCSD SpringerOpen |
| سنة النشر: | 2024 |
| المجموعة: | Archive Ouverte de l'Université Rennes (HAL) |
| مصطلحات موضوعية: | [SDV]Life Sciences [q-bio] |
| الوصف: | International audience ; Background: Evidence for the management of pregnant women with acute hypoxaemic respiratory failure (AHRF) is currently lacking. The likelihood of avoiding intubation and the risks of continuing the pregnancy under invasive ventilation remain undetermined. We report the management and outcome of pregnant women with pneumonia related to SARS-CoV-2 admitted to the ICU of tertiary maternity hospitals of the Paris area.Methods: We studied a retrospective cohort of pregnant women admitted to 15 ICUs with AHRF related to SARS-CoV-2 defined by the need for O2 ≥ 6 L/min, high-flow nasal oxygen (HFNO), non-invasive or invasive ventilation. Trajectories were assessed to determine the need for intubation and the possibility of continuing the pregnancy on invasive ventilation.Results: One hundred and seven pregnant women, 34 (IQR: 30-38) years old, at a gestational age of 27 (IQR: 25-30) weeks were included. Obesity was present in 37/107. Intubation was required in 47/107 (44%). Intubation rate according to respiratory support was 14/19 (74%) for standard O2, 17/36 (47%) for non-invasive ventilation and 16/52 (31%) for HFNO. Factors significantly associated with intubation were pulmonary co-infection: adjusted OR: 3.38 (95% CI 1.31-9.21), HFNO: 0.11 (0.02-0.41) and non-invasive ventilation: 0.20 (0.04-0.80). Forty-six (43%) women were delivered during ICU stay, 39/46 (85%) for maternal pulmonary worsening, 41/46 (89%) at a preterm stage. Fourteen non-intubated women were delivered under regional anaesthesia; 9/14 ultimately required emergency intubation. Four different trajectories were identified: 19 women were delivered within 2 days after ICU admission while not intubated (12 required prolonged intubation), 23 women were delivered within 2 days after intubation, in 11 intubated women pregnancy was continued allowing delivery after ICU discharge in 8/11, 54 women were never intubated (53 were delivered after discharge). Timing of delivery after intubation was mainly dictated by gestational age. ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/38890164; hal-04650991; https://hal.science/hal-04650991; https://hal.science/hal-04650991/document; https://hal.science/hal-04650991/file/s13613-024-01313-2.pdf; PUBMED: 38890164; PUBMEDCENTRAL: PMC11189363 |
| DOI: | 10.1186/s13613-024-01313-2 |
| الاتاحة: | https://hal.science/hal-04650991 https://hal.science/hal-04650991/document https://hal.science/hal-04650991/file/s13613-024-01313-2.pdf https://doi.org/10.1186/s13613-024-01313-2 |
| Rights: | http://creativecommons.org/licenses/by/ ; info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.4C5DAA30 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s13613-024-01313-2 |
|---|