CPAP using the PaO2/FiO2 is a successful first line tool in the treatment of Covid-19 related acute hypoxaemic respiratory failure

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
Category: COVID-19
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 (meanSD) (20792) compared to before CPAP initiation (p=0.03). The average day for CPAP treatment was (mean SD) 4.64.2 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.

Reference
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with Covid-10; a cause for concern? Lancet Respir Med 2020. https://doi.org/10.1016/S2213-
2600(20)30181-8