|Title:||CPAP using the PaO2/FiO2 is a successful first line tool in the treatment of Covid-19 related acute hypoxaemic respiratory failure|
|Author(s):||Shankar Lal, Eoin Nolan, Abdul Qadeer, Elaine Curran, Junaid Hashmi, Ian Counihan, Tidi Hassan, Ehtesham Khan|
|Institution:||Our Lady of Lourdes Hospital, Drogheda|
|Poster:||Click to view poster|
|Abstract:||One of the most important clinical debate for the treatment in of Covid-19 acute respiratory failure includes the role of non-invasive ventilation (NIV) such as continuous positive pressure (CPAP) and the threshold for mechanical ventilation (IMV) (1). 129 laboratory-confirmed Covid-19 patients in Our Lady of Lourdes Hospital were admitted. Twenty-seven patients with acute hypoxic respiratory failure that were not reaching target SaO2 and pO2 received CPAP during inpatient hospital stay with age (mean SD) of 59 13. Fourteen patients (37%) received at last three session of conscious prone position. Ten subjects subsequently were intubated and ventilated with two deaths. No death was observed in|
subjects receiving CPAP alone with a 100% success rate. PFR before CPAP initiation was negatively correlated with the maximum pressure to achieve target saturations (rs=-0.61,p=0.009)). PFR at 24 hours after commencement of CPAP was significantly higher (meanSD) (20792) compared to before CPAP initiation (p=0.03). The average day for CPAP treatment was (mean SD) 4.64.2 days.
In conclusion, this study urgently and importantly shows that CPAP is a useful first-line treatment for Covid-19 acute respiratory failure in a non-ICU setting. PFR is useful to determine response of CPAP which may avoid mechanical ventilation.
Arulkumaran N, Brealey D, Howell D, Singer M. Use of non0invasive ventilation for patients
with Covid-10; a cause for concern? Lancet Respir Med 2020. https://doi.org/10.1016/S2213-