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As a result, many hospitals turned to alternative respiratory therapies, including the use of gas-operated ventilators (GOV). The aim of this study was to describe the use of GOV as a noninvasive bridging respiratory therapy in critically ill COVID-19 patients and to compare clinical outcomes achieved with this device to conventional respiratory therapies. Retrospective cohort analysis of critically ill COVID-19 patients during the first local wave of the pandemic. The final analysis included 204 patients grouped according to the type of respiratory therapy received in the first 24\u00a0h, as follows: conventional oxygen therapy (COT), n\u2009=\u200928 (14%); GOV, n\u2009=\u200972 (35%); noninvasive ventilation (NIV), n\u2009=\u200949 (24%); invasive mechanical ventilation (IMV), n\u2009=\u200955 (27%). In 72, GOV served as noninvasive bridging respiratory therapy in 42 (58%) of these patients. In the other 30 patients (42%), 20 (28%) presented clinical improvement and were discharged; 10 (14%) died. In the COT and GOV groups, 68% and 39%, respectively, progressed to intubation (P\u2009\u2264\u20090.001). Clinical outcomes in the GOV and NIV groups were similar (no statistically significant differences). GOV was successfully used as a noninvasive bridging respiratory therapy in more than half of patients. Clinical outcomes in the GOV group were comparable to those of the NIV group. These findings support the use of GOV as an emergency, noninvasive bridging respiratory therapy in medical crises when alternative approaches to the standard of care may be justifiable.<\/jats:p>","DOI":"10.1007\/s11739-024-03681-w","type":"journal-article","created":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T00:03:28Z","timestamp":1719533008000},"page":"543-551","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of a gas-operated ventilator as a noninvasive bridging respiratory therapy in critically Ill COVID-19 patients in a middle-income country"],"prefix":"10.1007","volume":"20","author":[{"given":"Pedro P.","family":"Arias-Sanchez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro D.","family":"Wendel-Garcia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo A.","family":"Tirap\u00e9-Castro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Cobos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selena X.","family":"Jaramillo-Aguilar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna M.","family":"Pe\u00f1aloza-Tinoco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damary S.","family":"Jaramillo-Aguilar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Pablo","family":"Holgu\u00edn-Carvajal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrique","family":"Cabrera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferran","family":"Roche-Campo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7205-7020","authenticated-orcid":false,"given":"Hernan","family":"Aguirre-Bermeo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,28]]},"reference":[{"key":"3681_CR1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmp2006141","author":"ML Ranney","year":"2020","unstructured":"Ranney ML, Griffeth V, Jha AK (2020) Critical supply shortages\u2014the need for ventilators and personal protective equipment during the covid-19 pandemic. 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The RIsk Stratification in COVID-19 Patients in the ICU Registry (RISC-19-ICU) (2020, March 13 - 2022, March) https:\/\/clinicaltrials.gov\/ct2\/show\/study\/NCT04357275 Accessed 02 Feb 2023."}],"updated-by":[{"DOI":"10.1007\/s11739-024-03703-7","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2024,7,13]],"date-time":"2024-07-13T00:00:00Z","timestamp":1720828800000}}],"container-title":["Internal and Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11739-024-03681-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11739-024-03681-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11739-024-03681-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T16:38:26Z","timestamp":1744130306000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11739-024-03681-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,28]]},"references-count":47,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["3681"],"URL":"https:\/\/doi.org\/10.1007\/s11739-024-03681-w","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3287291\/v1","asserted-by":"object"}]},"ISSN":["1828-0447","1970-9366"],"issn-type":[{"value":"1828-0447","type":"print"},{"value":"1970-9366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,28]]},"assertion":[{"value":"26 August 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2024","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s11739-024-03703-7","URL":"https:\/\/doi.org\/10.1007\/s11739-024-03703-7","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This was a retrospective analysis of data retrieved from the multinational RICS-19-ICU registry. Due to the retrospective design, the ethics committee of the canton of Zurich (KEK 2020\u201300322) deemed that the study was exempt from the need for additional ethics approval and informed patient consent. The registry (ClinicalTrials.gov Identifier: NCT04357275), which mainly consists of basic clinical parameters obtained during the treatment of critically ill COVID-19 patients [\n                      \n                      ], has been endorsed by the Swiss Society of Intensive Care Medicine. The study also was approved by the teaching and research department of \u201cVicente Corral Moscoso\u201d hospital (017-UDI-HVCM-2020).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}