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Purpose: To explore the association of estimated plasma volume (ePV) and plasma volume status (PVS) as surrogates of volume status with new-onset AKI and in-hospital mortality among hospitalized COVID-19 patients., Materials and Methods: We performed a retrospective multi-center study on COVID-19-related ARDS patients who were admitted to the Mayo Clinic Enterprise health system. Plasma volume was calculated using the formulae for ePV and PVS, and longitudinal analysis was performed to find the association of ePV and PVS with new-onset AKI during hospitalization as the primary outcome and in-hospital mortality as a secondary outcome., Results: Our analysis included 7616 COVID-19 patients with new-onset AKI occurring in 1365 (17.9%) and a mortality rate of 25.96% among them. A longitudinal multilevel multivariate analysis showed both ePV (OR 1.162; 95% CI 1.048-1.288, p=0.004) and PVS (OR 1.032; 95% CI 1.012-1.050, p=0.001) were independent predictors of new onset AKI. Higher PVS was independently associated with increased in-hospital mortality (OR 1.038, 95% CI 1.007-1.070, p=0.017), but not ePV (OR 0.868, 95% CI 0.740-1.018, p=0.082)., Conclusion: A higher PVS correlated with a higher incidence of new-onset AKI and worse outcomes in our cohort of hospitalized COVID-19 patients. Further large-scale and prospective studies are needed to understand its utility., Competing Interests: Declaration of competing interest Rahul Kashyap: Grant and contracts - Gordan and Betty Moore Foundation, Jenssen and Jenssen LLC; all payments made to the institution. No conflict of interest related to this manuscript. Rest other authors declare that they have no competing interests., (Copyright © 2024 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)

Introduction: The COVID-19 vaccine became an effective instrument to prevent severe SARS-CoV-2 infections. However, 5% of vaccinated patients will have moderate or severe disease., Objective: to compare mortality and days between the symptom onset to the peak disease severity, in vaccinated vs. unvaccinated COVID-19 hospitalized patients., Methods: Retrospective observational study in 36 hospitals in Argentina. COVID-19 adults admitted to general wards between January 1, 2021, and May 31, 2022 were included. Days between symptoms onset to peak of severity were compared between vaccinated vs. unvaccinated patients with Cox regression, adjusted by Propensity Score Matching (PSM). Results in patients with one and two doses were also compared., Results: A total of 3663 patients were included (3001 [81.9%] unvaccinated and 662 [18%] vaccinated). Time from symptom onset to peak severity was 7 days (IQR 4-12) vs. 7 days (IQR 4-11) in unvaccinated and vaccinated. In crude Cox regression analysis and matched population, no significant differences were observed. Regarding mortality, a Risk Ratio (RR) of 1.51 (IC95% 1.29-1.77) was observed in vaccinated patients, but in the PSM cohort, the RR was 0.73 (IC95% 0.60-0.88). RR in patients with one COVID-19 vaccine dose in PSM adjusted population was 0.7 (IC95% 0.45-1.03), and with two doses 0.6 (IC95% 0.46-0.79)., Discussion: The time elapsed between the onset of COVID-19 symptoms to the highest severity was similar in vaccinated and unvaccinated patients. However, hospitalized vaccinated patients had a lower risk of mortality than unvaccinated patients.

Background: We aimed to report implant survival in Garden type I and II femoral neck fractures treated with cannulated screws in elderly patients., Methods: We retrospectively studied 232 consecutive unilateral Garden I and II patients (232 fractures) treated with cannulated screws. Mean age was 81 years (range, 65 to 100), and a body mass index of 25 (range, 15.8 to 38.3). No between-group differences were found in demographic variables and/or baseline measurements (P > .05). Mean follow-up was 36 months (range, 1 to 171). Two observers measured baseline radiographic variables with good-to-excellent interobserver reliability. The posterior tilt angle, measured on a cross-table lateral x-ray, was used to classify the cohort into <20° (n = 183) and ≥20° (n = 49). The cumulative incidence with competing risk analysis was used to predict association between posterior tilt and subsequent conversion to arthroplasty. Patient survival was calculated with the Kaplan-Meier estimate., Results: Implant survival was 86.3% (95% confidence interval (CI) 80 to 90) at 12 months and 77.3% (95% CI 64 to 86) at 70 months. The 12-month cumulative incidence failure was 12.6% (95% CI 8 to 17). After controlling for confounders, posterior tilt ≥20° had higher risk of subsequent arthroplasty when compared to posterior tilt <20° (38.8 [95% CI 25 to 52] versus 5% [95% CI 2.8 to 9], subhazard ratio 8.3, 95% CI 3.8 to 18), without any other radiologic or demographic factor being associated with failure. Patient survival was 88.2% (95% CI 83 to 91.7) at 12 months, 79.5% (95% CI 73 to 84) at 24 months, and 57% (95% CI 48 to 65) at 70 months., Conclusion: Cannulated screws were a reliable treatment for Garden I and II fractures, except when there was posterior tilt ≥20°, where arthroplasty should be considered., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Purpose: To evaluate the association of estimated plasma volume (ePV) and plasma volume status (PVS) on admission with the outcomes in COVID-19-related acute respiratory distress syndrome (ARDS) patients., Materials and Methods: We performed a retrospective multi-center study on COVID-19-related ARDS patients who were admitted to the Mayo Clinic Enterprise health system. Plasma volume was calculated using the formulae for ePV and PVS, and these variables were analyzed for correlation with patient outcomes., Results: Our analysis included 1298 patients with sequential organ failure assessment (SOFA) respiratory score ≥ 2 (PaO 2 /FIO 2 ≤300 mmHg) and a mortality rate of 25.96%. A Cox proportional multivariate analysis showed PVS but not ePV as an independent correlation with 90-day mortality after adjusting for the covariates (HR: 1.015, 95% CI: 1.005-1.025, p = 0.002 and HR 1.054, 95% CI 0.958-1.159, p = 0.278 respectively)., Conclusion: A lower PVS on admission correlated with a greater chance of survival in COVID-19-related ARDS patients. The role of PVS in guiding fluid management should be investigated in future prospective studies., Competing Interests: Declaration of Competing Interest Rahul Kashyap: Grant and contracts - Gordan and Betty Moore Foundation, Jenssen and Jenssen LLC; all payments made to the institution. No conflict of interest related to this manuscript. Archer Kilbourne Martin: Consulting fees - Scientific Advisory Board, Attgeno AB; payments made to the institution. No conflict of interest related to this manuscript. Rest other authors declare that they have no competing interests., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Importance: The scientific community debates Generative Pre-trained Transformer (GPT)-3.5's article quality, authorship merit, originality, and ethical use in scientific writing., Objectives: Assess GPT-3.5's ability to craft the background section of critical care clinical research questions compared to medical researchers with H-indices of 22 and 13., Design: Observational cross-sectional study., Setting: Researchers from 20 countries from six continents evaluated the backgrounds., Participants: Researchers with a Scopus index greater than 1 were included., Main Outcomes and Measures: In this study, we generated a background section of a critical care clinical research question on "acute kidney injury in sepsis" using three different methods: researcher with H-index greater than 20, researcher with H-index greater than 10, and GPT-3.5. The three background sections were presented in a blinded survey to researchers with an H-index range between 1 and 96. First, the researchers evaluated the main components of the background using a 5-point Likert scale. Second, they were asked to identify which background was written by humans only or with large language model-generated tools., Results: A total of 80 researchers completed the survey. The median H-index was 3 (interquartile range, 1-7.25) and most (36%) researchers were from the Critical Care specialty. When compared with researchers with an H-index of 22 and 13, GPT-3.5 was marked high on the Likert scale ranking on main background components (median 4.5 vs. 3.82 vs. 3.6 vs. 4.5, respectively; p < 0.001). The sensitivity and specificity to detect researchers writing versus GPT-3.5 writing were poor, 22.4% and 57.6%, respectively., Conclusions and Relevance: GPT-3.5 could create background research content indistinguishable from the writing of a medical researcher. It was marked higher compared with medical researchers with an H-index of 22 and 13 in writing the background section of a critical care clinical research question., Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)

Purpose: The primary purpose of this study was to describe the rate of volar locking plate (VLP) removal after distal radius fracture and how long it takes for the risk of VLP removal to stabilize. The secondary purpose was to describe the reasons for VLP removal and analyze the relationship between it and the Soong index., Methods: This was a single-center retrospective cohort study. Patients aged >18 years with distal radius fracture who underwent VLP fixation were included. Hardware removal, time until VLP removal, and the primary reason for removal were recorded. The implant prominence was measured as described by Soong. We used Kaplan-Meier curves and risk tables to describe the risk of VLP removal and variation over time. Multivariable logistic regression was used to assess the relationship between Soong grade and VLP removal., Results: A total of 313 wrists were included. There were 35 cases of VLP removal, with an overall incidence of 11.2% at 15 years of follow-up. The incidence rate was 1.2 per 100 individuals per year for the entire cohort. The risk of VLP removal decreased from 6.2% in the first postoperative year to 1.7% in the second year and 1.4% in the third year. Beyond that, the rate remained <1% per year throughout the follow-up period. The median hardware removal time was 11 months. The main reasons for VLP removal were tenosynovitis, implant-associated pain, and screw protrusion. We found no association between Soong grade and VLP removal., Conclusions: Volar locking plate removal after distal radius fracture was more common in the first year after surgery and remained notable until the third year. Regular monitoring and patient education to assess possible complications related to hardware are important during this period., Type of Study/level of Evidence: Therapeutic IV., (Copyright © 2023. Published by Elsevier Inc.)

Background: The emergence of new SARS-CoV-2 variants with significant immune-evasiveness, the relaxation of measures for reducing the number of infections, the waning of immune protection (particularly in high-risk population groups), and the low uptake of new vaccine boosters, forecast new waves of hospitalizations and admission to intensive care units. There is an urgent need for easily implementable and clinically effective Early Warning Scores (EWSs) that can predict the risk of complications within the next 24-48 hr. Although EWSs have been used in the evaluation of COVID-19 patients, there are several clinical limitations to their use. Moreover, no models have been tested on geographically distinct populations or population groups with varying levels of immune protection., Methods: We developed and validated COVID-19 Early Warning Score (COEWS), an EWS that is automatically calculated solely from laboratory parameters that are widely available and affordable. We benchmarked COEWS against the widely used NEWS2. We also evaluated the predictive performance of vaccinated and unvaccinated patients., Results: The variables of the COEWS predictive model were selected based on their predictive coefficients and on the wide availability of these laboratory variables. The final model included complete blood count, blood glucose, and oxygen saturation features. To make COEWS more actionable in real clinical situations, we transformed the predictive coefficients of the COEWS model into individual scores for each selected feature. The global score serves as an easy-to-calculate measure indicating the risk of a patient developing the combined outcome of mechanical ventilation or death within the next 48 hr.The discrimination in the external validation cohort was 0.743 (95% confidence interval [CI]: 0.703-0.784) for the COEWS score performed with coefficients and 0.700 (95% CI: 0.654-0.745) for the COEWS performed with scores. The area under the receiver operating characteristic curve (AUROC) was similar in vaccinated and unvaccinated patients. Additionally, we observed that the AUROC of the NEWS2 was 0.677 (95% CI: 0.601-0.752) in vaccinated patients and 0.648 (95% CI: 0.608-0.689) in unvaccinated patients., Conclusions: The COEWS score predicts death or MV within the next 48 hr based on routine and widely available laboratory measurements. The extensive external validation, its high performance, its ease of use, and its positive benchmark in comparison with the widely used NEWS2 position COEWS as a new reference tool for assisting clinical decisions and improving patient care in the upcoming pandemic waves., Funding: University of Vienna., Competing Interests: RK, IH, FG, AL, MP, NG, PV, MM, BB, RG, JC, JA, JP, DG No competing interests declared, (© 2023, Klén, Huespe et al.)

Background: The criteria for the selection of COVID-19 patients that could benefit most from ECMO organ support are yet to be defined. In this study, we evaluated the predictive performance of ECMO mortality predictive models in patients with COVID-19. We also performed a cost-benefit analysis depending on the mortality predicted probability. We conducted a retrospective cohort study in COVID-19 patients who received ECMO at two tertiary care hospitals between March 2020 to July 2021., Materials and Methods: We evaluated the discrimination (C-statistic), calibration (Cox calibration), and accuracy of the prediction of death due to severe ARDS in V-V ECMO score (PRESERVE), the Respiratory Extracorporeal Membrane Oxygenation Survival Score (RESP) score, and the PREdiction of Survival on ECMO Therapy-Score (PRESET) score. In addition, we compared the RESP score with Plateau pressure instead of Peak pressure., Results: We included a total of 36 patients, 29 (80%) of them male and with a median (IQR) APACHE of 10 (8-15). The PRESET score had the highest discrimination (AUROCs 0.81 [95%CI 0.67-0.94]) and calibration (calibration-in-the-large 0.5 [95%CI -1.4 to 0.3]; calibration slope 2.2 [95%CI 0.7/3.7]). The RESP score with Plateau pressure had higher discrimination than the conventional RESP score. The cost per QALY in the USA, adjusted to life expectancy, was higher than USD 100 000 in patients older than 45 years with a PRESET > 10., Conclusion: The PRESET score had the highest predictive performance and could help in the selection of patients that benefit most from this resource-demanding and highly invasive organ support., (© 2022 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)

The aim of this study was to analyze whether the coronavirus disease 2019 (COVID-19) vaccine reduces mortality in patients with moderate or severe COVID-19 disease requiring oxygen therapy. A retrospective cohort study, with data from 148 hospitals in both Spain (111 hospitals) and Argentina (37 hospitals), was conducted. We evaluated hospitalized patients for COVID-19 older than 18 years with oxygen requirements. Vaccine protection against death was assessed through a multivariable logistic regression and propensity score matching. We also performed a subgroup analysis according to vaccine type. The adjusted model was used to determine the population attributable risk. Between January 2020 and May 2022, we evaluated 21,479 COVID-19 hospitalized patients with oxygen requirements. Of these, 338 (1.5%) patients received a single dose of the COVID-19 vaccine and 379 (1.8%) were fully vaccinated. In vaccinated patients, mortality was 20.9% (95% confidence interval [CI]: 17.9-24), compared to 19.5% (95% CI: 19-20) in unvaccinated patients, resulting in a crude odds ratio (OR) of 1.07 (95% CI: 0.89-1.29; p = 0.41). However, after considering the multiple comorbidities in the vaccinated group, the adjusted OR was 0.73 (95% CI: 0.56-0.95; p = 0.02) with a population attributable risk reduction of 4.3% (95% CI: 1-5). The higher risk reduction for mortality was with messenger RNA (mRNA) BNT162b2 (Pfizer) (OR 0.37; 95% CI: 0.23-0.59; p < 0.01), ChAdOx1 nCoV-19 (AstraZeneca) (OR 0.42; 95% CI: 0.20-0.86; p = 0.02), and mRNA-1273 (Moderna) (OR 0.68; 95% CI: 0.41-1.12; p = 0.13), and lower with Gam-COVID-Vac (Sputnik) (OR 0.93; 95% CI: 0.6-1.45; p = 0.76). COVID-19 vaccines significantly reduce the probability of death in patients suffering from a moderate or severe disease (oxygen therapy)., (© 2023 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.)

Purpose: Alactic base excess (ABE) is a novel biomarker defined as the sum of lactate and standard base excess and estimates the renal capability of handling acid-base disturbances in sepsis. The objective of this study is to see if ABE is an independent predictor of mortality in septic patients with and without renal dysfunction., Materials and Methods: We retrospectively studied 1178 patients with sepsis and septic shock. Patients were divided according to ABE values: 1) negative ABE (<-3 mmol/L); 2) neutral ABE (≥ - 3 and < 4 mmol/L); and 3) positive ABE (≥4 mmol/L). The effect of ABE on mortality was evaluated using Cox regression weight by inverse probability weighting (IPWT) analysis after propensity score assessment. Additionally, we performed a stratified analysis in patients with GFR > 60 mL/min/1.73 m2., Results: Negative ABE patients had higher mortality than patients with neutral ABE (adjusted HR 1.43; 95%CI 1.02-2.01). Also, in patients with GFR > 60 mL/min/1.73 m2 (n = 493), we observed higher mortality in patients with negative ABE (adjusted HR 2.43; 95%CI 1.07-5.53)., Conclusions: Negative ABE is an independent predictor of in-hospital mortality in septic patients with and without renal dysfunction., Competing Interests: Declaration of Competing Interest Authors declare no conflicts of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Assessment of the efficacy and complications associated with performing bronchoscopy-guided percutaneous tracheostomy in COVID-19 and non-COVID-19 patients., Methods: Prospective observational study conducted between March of 2020 and February of 2022. All adult patients who underwent elective bronchoscopy-guided percutaneous tracheostomy were included. The efficacy of the procedure was evaluated based either on the success rate in the execution or on the need for conversion to open technique. Percutaneous tracheostomy-related complications were registered during the procedure. We performed 6-month follow-up for identifying late complications., Results: During the study period, 312 bronchoscopy-guided percutaneous tracheostomies were analyzed. One hundred and eighty-three were performed in COVID-19 patients and 129 among non-COVID-19 patients. Overall, 64.1% (200) of patients were male, with a median age of 66 (interquartile range 54-74), and 65% (205) presented at least 1 comorbidity. Overall, oxygen desaturation was the main complication observed (20.8% [65]), being more frequent in the COVID-19 group occurring in 27.3% (50) with a statistically significant difference versus the non-COVID-19 patients' group (11.6% [15]); P < .01). Major complications such as hypotension, arrhythmias, and pneumothorax were more frequently observed among COVID-19 patients as well but with no significant differences. Percutaneous tracheostomy could be executed quickly and satisfactorily in all the patients with no need for conversion to the open technique. Likewise, no suspension of the procedure was required in any case. During 6-month follow-up, we found an incidence of 0.96% (n = 3) late complications, 2 tracheal granulomas, and 1 ostomal infection., Conclusion: Bronchoscopy-guided percutaneous tracheostomy can be considered an effective and safe procedure in COVID-19 patients. Nevertheless, it is highly remarkable that in the series under study, a great number of COVID-19 patients presented oxygen desaturation during the procedure., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Introduction: Nonattendance is a critical problem that affects health care worldwide. Our aim was to build and validate predictive models of nonattendance in all outpatients appointments, general practitioners, and clinical and surgical specialties., Methods: A cohort study of adult patients, who had scheduled outpatient appointments for General Practitioners, Clinical and Surgical specialties, was conducted between January 2015 and December 2016, at the Italian Hospital of Buenos Aires. We evaluated potential predictors grouped in baseline patient characteristics, characteristics of the appointment scheduling process, patient history, characteristics of the appointment, and comorbidities. Patients were divided between those who attended their appointments, and those who did not. We generated predictive models for nonattendance for all appointments and the three subgroups., Results: Of 2,526,549 appointments included, 703,449 were missed (27.8%). The predictive model for all appointments contains 30 variables, with an area under the ROC (AUROC) curve of 0.71, calibration-in-the-large (CITL) of 0.046, and calibration slope of 1.03 in the validation cohort. For General Practitioners the model has 28 variables (AUROC of 0.72, CITL of 0.053, and calibration slope of 1.01). For clinical subspecialties, the model has 23 variables (AUROC of 0.71, CITL of 0.039, and calibration slope of 1), and for surgical specialties, the model has 22 variables (AUROC of 0.70, CITL of 0.023, and calibration slope of 1.01)., Conclusion: We build robust predictive models of nonattendance with adequate precision and calibration for each of the subgroups., (© 2022 John Wiley & Sons Ltd.)

Objective: Investigate the predictive value of NEWS2, NEWS-C, and COVID-19 Severity Index for predicting intensive care unit (ICU) transfer in the next 24 h., Design: Retrospective multicenter study., Setting: Two third-level hospitals in Argentina., Patients: All adult patients with confirmed COVID-19, admitted on general wards, excluding patients with non-intubated orders., Interventions: Patients were divided between those who were admitted to ICU and non-admitted. We calculated the three scores for each day of hospitalization., Variables: We evaluate the calibration and discrimination of the three scores for the outcome ICU admission within 24, 48 h, and at hospital admission., Results: We evaluate 13,768 days of hospitalizations on general medical wards of 1318 patients. Among these, 126 (9.5%) were transferred to ICU. The AUROC of NEWS2 was 0.73 (95%CI 0.68-0.78) 24 h before ICU admission, and 0.52 (95%CI 0.47-0.57) at hospital admission. The AUROC of NEWS-C was 0.73 (95%CI 0.68-0.78) and 0.52 (95%CI 0.47-0.57) respectively, and the AUROC of COVID-19 Severity Index was 0.80 (95%CI 0.77-0.84) and 0.61 (95%CI 0.58-0.66) respectively. COVID-19 Severity Index presented better calibration than NEWS2 and NEWS-C., Conclusion: COVID-19 Severity index has better calibration and discrimination than NEWS2 and NEWS-C to predict ICU transfer during hospitalization., (© 2021 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.)

Objective: Investigate the predictive value of NEWS2, NEWS-C, and COVID-19 Severity Index for predicting intensive care unit (ICU) transfer in the next 24h., Design: Retrospective multicenter study., Setting: Two third-level hospitals in Argentina., Patients: All adult patients with confirmed COVID-19, admitted on general wards, excluding patients with non-intubated orders., Interventions: Patients were divided between those who were admitted to ICU and non-admitted. We calculated the three scores for each day of hospitalization., Variables: We evaluate the calibration and discrimination of the three scores for the outcome ICU admission within 24, 48h, and at hospital admission., Results: We evaluate 13,768 days of hospitalizations on general medical wards of 1318 patients. Among these, 126 (9.5%) were transferred to ICU. The AUROC of NEWS2 was 0.73 (95%CI 0.68-0.78) 24h before ICU admission, and 0.52 (95%CI 0.47-0.57) at hospital admission. The AUROC of NEWS-C was 0.73 (95%CI 0.68-0.78) and 0.52 (95%CI 0.47-0.57) respectively, and the AUROC of COVID-19 Severity Index was 0.80 (95%CI 0.77-0.84) and 0.61 (95%CI 0.58-0.66) respectively. COVID-19 Severity Index presented better calibration than NEWS2 and NEWS-C., Conclusion: COVID-19 Severity index has better calibration and discrimination than NEWS2 and NEWS-C to predict ICU transfer during hospitalization., (Copyright © 2021 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.)

New SARS-CoV-2 variants, breakthrough infections, waning immunity, and sub-optimal vaccination rates account for surges of hospitalizations and deaths. There is an urgent need for clinically valuable and generalizable triage tools assisting the allocation of hospital resources, particularly in resource-limited countries. We developed and validate CODOP, a machine learning-based tool for predicting the clinical outcome of hospitalized COVID-19 patients. CODOP was trained, tested and validated with six cohorts encompassing 29223 COVID-19 patients from more than 150 hospitals in Spain, the USA and Latin America during 2020-22. CODOP uses 12 clinical parameters commonly measured at hospital admission for reaching high discriminative ability up to 9 days before clinical resolution (AUROC: 0·90-0·96), it is well calibrated, and it enables an effective dynamic risk stratification during hospitalization. Furthermore, CODOP maintains its predictive ability independently of the virus variant and the vaccination status. To reckon with the fluctuating pressure levels in hospitals during the pandemic, we offer two online CODOP calculators, suited for undertriage or overtriage scenarios, validated with a cohort of patients from 42 hospitals in three Latin American countries (78-100% sensitivity and 89-97% specificity). The performance of CODOP in heterogeneous and geographically disperse patient cohorts and the easiness of use strongly suggest its clinical utility, particularly in resource-limited countries., Competing Interests: RK, DP, RG, JC, JA, JN, CL, JR, NG, MP, AL, MM, FR, MO, PY, JR, ET, RG, MC, PV, FP, RC, IH, BB, JP, NF, BL, DG No competing interests declared, (© 2022, Klén et al.)

Objective: To analyze whether changes in medical care due to the application of COVID-19 protocols affected clinical outcomes in patients without COVID-19 during the pandemic., Methods: This was a retrospective, observational cohort study carried out in a thirty-eight-bed surgical and medical intensive care unit of a high complexity private hospital. Patients with respiratory failure admitted to the intensive care unit during March and April 2020 and the same months in 2019 were selected. We compared interventions and outcomes of patients without COVID-19 during the pandemic with patients admitted in 2019. The main variables analyzed were intensive care unit respiratory management, number of chest tomography scans and bronchoalveolar lavages, intensive care unit complications, and status at hospital discharge., Results: In 2020, a significant reduction in the use of a high-flow nasal cannula was observed: 14 (42%) in 2019 compared to 1 (3%) in 2020. Additionally, in 2020, a significant increase was observed in the number of patients under mechanical ventilation admitted to the intensive care unit from the emergency department, 23 (69%) compared to 11 (31%) in 2019. Nevertheless, the number of patients with mechanical ventilation after 5 days of admission was similar in both years: 24 (69%) in 2019 and 26 (79%) in 2020., Conclusion: Intensive care unit protocols based on international recommendations for the COVID-19 pandemic have produced a change in non-COVID-19 patient management. We observed a reduction in the use of a high-flow nasal cannula and an increased number of tracheal intubations in the emergency department. However, no changes in the percentage of intubated patients in the intensive care unit, the number of mechanical ventilation days or the length of stay in intensive care unit.