Continuous Positive Airway Pressure (CPAP) face-mask ventilation is an easy and cheap option to manage a massive influx of patients presenting acute respiratory failure during the SARS-CoV-2 outbreak: A retrospective cohort study

Alviset, Sophie; Riller, Quentin; Aboab, Jérôme; Dilworth, Kelly; Billy, Pierre-Antoine; Lombardi, Yannis; Azzi, Mathilde; Vargas, Luis Ferreira; Lainé, Laurent; Lermuzeaux, Mathilde; Mémain, N.; Silva, Daniel; Tchoubou, Tona; Ushmorova, Daria; Dabbagh, Hossein A.; Escoda, Simon; Lefrançois, Rémi; Nardi, A.; Ngima, Armand; Ioos, Vincent

doi:10.1371/journal.pone.0240645

Cited by 56 publications

(57 citation statements)

References 45 publications

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“…In general, the studies have shown that the treatment with CPAP was well tolerated with few patients dropping out. Still, the intubation rate was high between 42% and 57% [ 7 , 8 , 10 , 12 ] among those without a ceiling of treatment in the ward and comparable to our study. Only one study had 83% recovering from CPAP treatment alone [ 11 ].…”

Section: Discussionsupporting

confidence: 90%

COVID-19 and acute respiratory failure treated with CPAP

Kofod

Jeschke

Kristensen

et al. 2021

European Clinical Respiratory Journal

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Introduction: Patients admitted with COVID-19 often have severe hypoxemic respiratory insufficiency and it can be difficult to maintain adequate oxygenation with oxygen supplementation alone. There is a physiological rationale for the use of Continuous Positive Airway Pressure (CPAP), and CPAP could keep some patients off mechanical ventilation. We aimed to examine the physiological response to CPAP and the outcome of this treatment. Methods : Data from all patients admitted with COVID-19 and treated with CPAP, from March to July 2020 were collected retrospectively. CPAP was initiated on a medical ward when oxygen supplementation exceeded 10 liters/min to maintain oxygen saturation (SpO 2 ) ≥92%. CPAP was administered with full face masks on a continuous basis until stable improvement in oxygenation or until intubation or death. Results: CPAP was initiated in 53 patients (35 men, 18 women) with a median (IQR) age of 68 (57–78) years. Nine patients were not able to tolerate the CPAP treatment. Median duration for the 44 patients receiving CPAP was 3 (2–6) days. The PaO 2 /FiO 2 ratio was severely reduced to an average of 101 mmHg at initiation of treatment. A positive response of CPAP was seen on respiratory rate (p = 0.002) and on oxygenation (p < 0.001). Of the 44 patients receiving CPAP, 12 (27%) avoided intubation,13 (29%) were intubated, and 19 (43%) died. Of the patients with a ceiling of treatment in the ward (26 of 53) only 2 survived. Older age and high initial oxygen demand predicted treatment failure. Discussion: CPAP seems to have positive effect on oxygenation and respiratory rate in most patients with severe respiratory failure caused by COVID-19. Treatment with CPAP to severely hypoxemic patients in a medical ward is possible, but the prognosis for especially elderly patients with high oxygen requirement and with a ceiling of treatment in the ward is poor.

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Section: Discussionsupporting

confidence: 90%

COVID-19 and acute respiratory failure treated with CPAP

Kofod

Jeschke

Kristensen

et al. 2021

European Clinical Respiratory Journal

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“…Recent experience in COVID-19 related Acute respiratory failure (21 publications including 1553 patients) 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 with HFNC, CPAP and Bi-Level Ventilation (using negative pressure rooms in only one series 15 ) shows average success of 60%, 55% and 59%, respectively, and an average infection rate in health professionals of 5.2%, less than the 12% reported in New York City among the staff not necessarily working with NIRT. 28 …”

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confidence: 99%

Non-invasive respiratory support paths in hospitalized patients with COVID-19: proposal of an algorithm

Scala

2021

Pulmonology

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“…Some experiences conducted in the first phase of the epidemic in Europe in the operational context of the Emergency Department (ED) have described a situation characterized by an exponential growth of admitted patients and the urgent need to make more beds available in the ICU, coupled with their rapid occupation [10][11][12]. Criteria for initiating CPAP or non-invasive positive pressure ventilation (NPPV) in the various studies were a PaO2 of less than 60 mmHg or an oxygen saturation lower than 90-94% and or a respiratory rate greater than 25 per minute and signs of respiratory distress after application of non-rebreathing mask.…”

Section: The Outbreak Of the Pandemicmentioning

confidence: 99%

Non-invasive respiratory support in the treatment of acute hypoxemic respiratory failure secondary to CoViD-19 related pneumonia

Groff

Ferrari²

2021

European Journal of Internal Medicine

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In the last 11 months, the SARS-CoV-2 pandemic has overwhelmed and disrupted the whole world in health, social and economic terms. We are progressively learning more and more about the epidemiological and clinical features that distinguish CoViD-19 from any previous experience in the emergency and critical care setting. Experiences are multiplying with regard to the use of non-invasive respiratory support techniques in the context of acute hypoxemic respiratory failure secondary to CoViD-19-related pneumonia. Doubts still far outweigh certainties, but a growing series of mostly monocentric and retrospective studies are becoming available as concrete decision-making and operational support for healthcare workers. In this review the available studies and experiences about non-invasive respiratory support in the treatment of Covid-19 related respiratory failure, mainly coming from outside the ICU setting, will be discussed.

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Continuous Positive Airway Pressure (CPAP) face-mask ventilation is an easy and cheap option to manage a massive influx of patients presenting acute respiratory failure during the SARS-CoV-2 outbreak: A retrospective cohort study

Abstract: Positive Airway Pressure (CPAP) face-mask ventilation is an easy and cheap option to manage a massive influx of patients presenting acute respiratory failure during the SARS-CoV-2 outbreak: A retrospective cohort study. PLoS ONE 15(10): e0240645.

Cited by 56 publications

References 45 publications

COVID-19 and acute respiratory failure treated with CPAP

COVID-19 and acute respiratory failure treated with CPAP

Non-invasive respiratory support paths in hospitalized patients with COVID-19: proposal of an algorithm

Non-invasive respiratory support in the treatment of acute hypoxemic respiratory failure secondary to CoViD-19 related pneumonia

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