Effectiveness of Non-Invasive vs. Invasive Ventilation in Acute Hypoxic Respiratory Failure in COVID-19 Patients in Critical Care: A Retrospective Cohort in Rahim Yar Khan, Pakistan

Background: Acute hypoxic respiratory failure (AHRF) is the most common reason of ICU admissions. Invasive (IV) and non-invasive ventilation (NIV) methods are incorporated in ICUs as part of initial treatment. Objective: To compare the outcomes of COVID-19 patients with acute hypoxic respiratory failure on non-invasive and invasive ventilation. Study type, settings & duration: This retrospective cohort study was conducted at Intensive Care Unit, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from March to August 2020. Methodology: The 72 COVID-19 positive patients, placed in two groups “IV” (invasive ventilation) and “NIV” (non-invasive ventilation) as per treatment they received in ICU. Outcome was defined in terms of patient’s survival and number of complications associated with both modes of ventilation. Results: More patients showed survival on NIV than on IV (36.6 % vs. 6.4% respectively) with a significant p =0.003. Number of complications was low in NIV group vs. IV group. Males were more affected than females (83.3% vs. 16.7%). Middle and old aged groups were more prone to develop severe hypoxia and required ICU admission as compared to young people (47.2% vs. 37.5% vs. 15.3%) respectively with p=0.017, reflecting better survival in younger people. Conclusion: NIV should be prioritized in ICUs for early management of acute hypoxic respiratory failure associated with COVID-19 as NIV has negligible adverse affects and better outcome than IV.