الفهرس 
Role of integrated pulmonary index in respiratory monitoring of spontaneously breathing covid-19 patients with moderate to severe respiratory symptoms
TABLE OF CONTENTSOnly 14 pages are availabe for public view
 |  | from | 85 |  |  |
| | | from | 85 | | |
Abstract
Currently, no published data exist assessing the use of either end tidal CO2 or IPI‟s in spontaneously breathing COVID-19 patients with moderate to severe respiratory symptoms. The aim of this prospective observational study is primarily to determine the correlation between end tidal Co2 and SpO2 in these patients and secondary to examine whether IPI values will differ significantly for subjects who will need mechanical ventilation compared to those who managed successfully without intubation.
Methods: In this prospective observational study, we included adult patients with COVID-19 virus admitted to ICU with severe respiratory symptoms who were Spontaneously breathing .The patients connected to the bedside Oridion CS20 monitor (Medtronic) with the IPI algorithm. The monitor‟s pulse oximeter probe attacheded to the subject, and the capnography (CO2) sampling filter line (Medtronic) placed. An arterial catheter placed in all patients ,they were treated according to our standardized respiratory protocol. The oxygen flow was adjusted to maintain an oxygen saturation (SpO2) of 92%–96%. If the RR didn‟t fall below 30 breaths/min and/or the SpO2 did not reach the target, NIV was initiated . A patient who developed any feature of NIV failure was qualified to receive invasive mechanical ventilation . Baseline CT chest during patient admission analyzed by chest radiologist. The outcomes included Correlation between End tidal CO2 and SpO2 at baseline before oxygen therapy and Correlation of IPI score with CT severity score.
Results: fourty patients were available for the final analysis. We found a significant positive correlation between End tidal CO2 and SpO2 at baseline before oxygen therapy (r = 0.419; P < .007). There was a significant negative correlation between CT score and SpO2, however, there was no correlation between CT score and both IPI and End tidal CO2 at baseline. Five patients (12.5%) needed oxygen mask alone, while 35 patients (88.5%) required mechanically ventilatory support. The etco2 /paco2 ratio was positive correlated with spo2, the ratio not significant with Ct score. IPI is not significant between intubated and non- intubated patients, however this finding was not consisting among all its components.
Conclusion: The IPI can not be used as a single parameter for assessment of severity of respiratory status of the covid 19 patients. The higher value of IPI in patient who need oxygen therapy alone might need a larger study.