Non-Invasive Respiratory Support Strategies In Covid-19 Pneumonia

Title: Non-Invasive Respiratory Support Strategies In Covid-19 Pneumonia
Author(s): L Kingsmore L Davidson C Bradley M Drain W Anderson
Institution: Antrim Area Hospital
Poster: Click to view poster
Category: COVID-19
Abstract: Evidence suggests that the use of continuous positive airway pressure (CPAP) in Covid-19 pneumonitis can avoid intubation in some patients. High flow nasal oxygen (HFNO) use has been contentious.

We retrospectively reviewed the clinical notes for all respiratory patients admitted between March 1 st and May 31st 2020 to identify patients with a diagnosis of COVID-19 pneumonitis requiring respiratory support and recorded patient demographics and outcomes.

56 patients who received respiratory support were identified. The median age (IQR) was 65 (54,77 years), 65% were male, and overall mortality was 44%. 3 (5%) patients were intubated without trial of non-invasive ventilation (NIV) and 1 patient received BiPAP (Bilevel positive airway pressure) due to underlying COPD.

The table below demonstrates the results.

Initial respiratory support CPAP HFNO
Number of cases 27 25
Median Age (IQR) 63(54,77) 70(58,79)
Mortality 43% 48%
Subsequent trial of
alternative non-invasive
respiratory support 56%(n=15) 12%(n=3)

Required invasive
ventilation 36%(n=10) 28%(n=7)

In conclusion, the mortality in patients with COVID-19 pneumonia who required respiratory support was high, and over half of the patients for full escalation in the event of treatment failure required invasive ventilation. Further studies are clearly required, comparing patient comorbidities and outcomes using different modalities of respiratory support.