Non-invasive respiratory support in the management of COVID-19: Report of a series using a nasal CPAP mask

https://doi.org/10.1016/j.tacc.2021.04.008Get rights and content

Highlights

  • The Covid-19 pandemic created a dramatic influx of patients in respiratory failure.

  • We improvised to provide ventilatory support for these critically ill patients.

  • We used the SuperNO2VA to provide NIV for patients in respiratory failure.

  • 71% of our patients treated with SuperNO2VA did not require intubation.

  • Further studies are needed to clarify the role of SuperNO2VA for NIV.

Abstract

Background

During peak pandemic period of COVID-19, our hospital required rapid reorganization of resources and staff during between mid-March and early April 2020. Within this interval, the hospital responded to an overwhelming rate of admissions of patients in respiratory failure, rapidly reaching over 95% of its usual inpatient bed capacity and requiring 70 extra critical care beds and at least 40 intermediate care unit beds. This created a significant shortage of materials including ventilation equipment, requiring improvised use of available resources.

Aims

To describe our use of non-invasive ventilation (NIV) with the continuous positive nasal airway pressure (CPAP) device SuperNO2VA™ (Vyaire Medical, Mettawa, IL) with hospitalized patients in acute respiratory failure due to presumed COVID-19.

Methods

We performed a retrospective analysis of 14 inpatients receiving NIV CPAP at the Hospital Ramón y Cajal in Madrid, Spain. These were inpatients presenting in respiratory failure during the peak pandemic period based on defined respiratory health, oxygenation, and comorbidity status criteria. Patient data were retrospectively acquired from patient medical records.

Results

All 14 patients were reviewed. Our series consisted of 11 males and three females with an average age of 61.5 years. Ten of 14 patients (71.4%) NIV CPAP patients did not require intubation or reintubation. Of the four unsuccessful cases, one required intubation, two required reintubation, and one expired.

Conclusions

In a time of crisis, anesthesiologists and respiratory specialists implemented the use of NIV CPAP with SuperNO2VA to help meet the high care demand of patients in respiratory distress. Although the SuperNO2VA was not originally developed for the management of patients in respiratory failure or distress related to COVID-19, this case series demonstrates it can be used with mostly favorable results during a time of limited resources to improve the clinical situation in patients. Advantages and disadvantages are explored.

Keywords

Respiratory airflow
Noninvasive ventilation
Respiratory insufficiency
Respiratory distress syndrome
Adult
Severe acute respiratory syndrome
Coronavirus

Cited by (0)

Institution where work was performed: Hospital Ramón y Cajal, Ctra. de Colmenar Viejo km. 9, 100 28034 Madrid, Spain.

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