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SESSION TITLE: Critical Care Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: After the novel coronavirus disease (COVID-19), was declared a pandemic, New York quickly became the new epicenter of the disease, with Queens County reporting the most confirmed cases in the United States This study was conducted during the peak of COVID-19 in Queens Due to the severity of the disease and limited resources, patients were intubated at varying degrees of oxygenation This study examines the preoxygenation state of COVID-19 ARDS patients prior to intubation and its implication on clinical outcomes METHODS: At a single acute tertiary care hospital located in Queens, New York, all patients admitted between March 15 and April 15, 2020 were screened Active COVID-19 status was confirmed with reverse transcriptase-polymerase chain reaction assay on nasopharyngeal samples All COVID-19 patients who were intubated with documented pre-intubation oxygen saturation (PreO2) were included All data were collected from the electronic health record, including laboratory data, ventilator settings, and hospital course Peri-intubation cardiac arrest events up to 24 hours post-intubation and mortality during the study period were examined as outcomes Data was analyzed with SPSS (version 25) Continuous variables were tested using independent T-tests All tests of significance were two-tailed, and a p-value of 0 05 was considered significant RESULTS: A total of 192 patients were included in the study They had a mean age of 61 2 ± 12 2 years, and 130 (64 1%) were men The mean preO2 of all patients was 71 3 ± 13 6, and the mean peri-intubation PF ratio was 120 84 ± 58 6 32 out of 192 patients (16 7%) with peri-intubation cardiac arrest demonstrated significantly lower preO2 (p=0 03) compared to those without These 32 patients also demonstrated more days with symptoms prior to intubation (p=0 004) 121 patients who expired during the clinical course demonstrated lower PreO2 (p=0 60) and PF Ratios (p=0 48) compared to the 71 patients who did not, but these comparisons were not statistically significant Patients who expired demonstrated fewer symptomatic days prior to intubation than those who did not, but this was not statistically significant (p=0 06) CONCLUSIONS: At the time of intubation, the patients had significant hypoxemia and severe ARDS by PF ratio Lower oxygenation prior to intubation is associated with an increase in peri-intubation complications CLINICAL IMPLICATIONS: Due to unclear pathophysiology of ARDS in COVID-19, the optimal timing of intubation continues to be debated Physicians should consider intubation earlier in the disease course prior to significant hypoxemia, which may have a negative impact on peri-intubation complications Clinical outcome was further impacted by the restriction on preoxygenation of the patients prior to intubation, given its risk of viral aerosolization Means of preoxygenating with minimal risk of disease spread should continue to be explored DISCLOSURES: Advisory Committee Member relationship with Ambu Please note: $1-$1000 by Olumayowa Abe, source=Admin input, value=Honoraria No relevant relationships by Ahmed Al-Ghrairi, source=Web Response No relevant relationships by Christian Castaneda, source=Web Response No relevant relationships by Ettaib El Marabti, source=Web Response No relevant relationships by Hadya Elshakh, source=Web Response No relevant relationships by Teressa Ju, source=Web Response No relevant relationships by Michael Karass, source=Admin input No relevant relationships by Miri Kim, source=Web Response No relevant relationships by Jack Mann, source=Web Response No relevant relationships by Christina Jee Ah Rhee, source=Web Response No relevant relationships by Fizza Sajid, source=Web Response No relevant relationships by Angelina Voronina, source=Web Response
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