tetano
Editor, Senior Moderator
ERJ Open Res
. 2021 Oct 4;7(4):00318-2021.
doi: 10.1183/23120541.00318-2021. eCollection 2021 Oct.
Outcomes and characteristics of COVID-19 patients treated with continuous positive airway pressure/high-flow nasal oxygen outside the intensive care setting
Dominic L Sykes[SUP] 1 [/SUP], Michael G Crooks[SUP] 1 2 [/SUP], Khaing Thu Thu[SUP] 1 [/SUP], Oliver I Brown[SUP] 1 [/SUP], Theodore J P Tyrer[SUP] 1 [/SUP], Jodie Rennardson[SUP] 1 [/SUP], Catherine Littlefield[SUP] 1 [/SUP], Shoaib Faruqi[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background: Continuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO) have been used to manage hypoxaemic respiratory failure secondary to coronavirus disease 2019 (COVID-19) pneumonia. Limited data are available for patients treated with noninvasive respiratory support outside of the intensive care setting.
Methods: In this single-centre observational study we observed the characteristics, physiological observations, laboratory tests and outcomes of all consecutive patients with COVID-19 pneumonia between April 2020 and March 2021 treated with noninvasive respiratory support outside of the intensive care setting.
Results: We report the outcomes of 140 patients (mean±sd age: 71.2±11.1, 65% male (n=91)) treated with CPAP/HFNO outside of the intensive care setting. Overall mortality was 59% and was higher in those deemed unsuitable for mechanical ventilation (72%). The mean age of survivors was significantly lower than those who died (66.1 versus 74.4 years, p<0.001). Those who survived their admission also had a significantly lower median Clinical Frailty Score than the non-survivor group (2 versus 4, p<0.001). We report no significant difference in mortality between those treated with CPAP (n=92, mortality: 60%) or HFNO (n=48, mortality: 56%). Treatment was well tolerated in 86% of patients receiving either CPAP or HFNO.
Conclusions: CPAP and HFNO delivered outside of the intensive care setting are viable treatment options for patients with hypoxaemic respiratory failure secondary to COVID-19 pneumonia, including those considered unsuitable for invasive mechanical ventilation. This provides an opportunity to safeguard intensive care capacity for COVID-19 patients requiring invasive mechanical ventilation.
. 2021 Oct 4;7(4):00318-2021.
doi: 10.1183/23120541.00318-2021. eCollection 2021 Oct.
Outcomes and characteristics of COVID-19 patients treated with continuous positive airway pressure/high-flow nasal oxygen outside the intensive care setting
Dominic L Sykes[SUP] 1 [/SUP], Michael G Crooks[SUP] 1 2 [/SUP], Khaing Thu Thu[SUP] 1 [/SUP], Oliver I Brown[SUP] 1 [/SUP], Theodore J P Tyrer[SUP] 1 [/SUP], Jodie Rennardson[SUP] 1 [/SUP], Catherine Littlefield[SUP] 1 [/SUP], Shoaib Faruqi[SUP] 1 2 [/SUP]
Affiliations
- PMID: 34611525
- PMCID: PMC8287575
- DOI: 10.1183/23120541.00318-2021
Abstract
Background: Continuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO) have been used to manage hypoxaemic respiratory failure secondary to coronavirus disease 2019 (COVID-19) pneumonia. Limited data are available for patients treated with noninvasive respiratory support outside of the intensive care setting.
Methods: In this single-centre observational study we observed the characteristics, physiological observations, laboratory tests and outcomes of all consecutive patients with COVID-19 pneumonia between April 2020 and March 2021 treated with noninvasive respiratory support outside of the intensive care setting.
Results: We report the outcomes of 140 patients (mean±sd age: 71.2±11.1, 65% male (n=91)) treated with CPAP/HFNO outside of the intensive care setting. Overall mortality was 59% and was higher in those deemed unsuitable for mechanical ventilation (72%). The mean age of survivors was significantly lower than those who died (66.1 versus 74.4 years, p<0.001). Those who survived their admission also had a significantly lower median Clinical Frailty Score than the non-survivor group (2 versus 4, p<0.001). We report no significant difference in mortality between those treated with CPAP (n=92, mortality: 60%) or HFNO (n=48, mortality: 56%). Treatment was well tolerated in 86% of patients receiving either CPAP or HFNO.
Conclusions: CPAP and HFNO delivered outside of the intensive care setting are viable treatment options for patients with hypoxaemic respiratory failure secondary to COVID-19 pneumonia, including those considered unsuitable for invasive mechanical ventilation. This provides an opportunity to safeguard intensive care capacity for COVID-19 patients requiring invasive mechanical ventilation.