TY - JOUR T1 - Conservative management of COVID-19 associated hypoxaemia JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00026-2021 VL - 7 IS - 1 SP - 00026-2021 AU - Thomas Voshaar AU - Patrick Stais AU - Dieter Köhler AU - Dominic Dellweg Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/7/1/00026-2021.abstract N2 - Background Invasive mechanical ventilation of hypoxaemic coronavirus disease 2019 (COVID-19) patients is associated with mortality rates of >50%. We evaluated clinical outcome data of two hospitals that agreed on a predefined protocol for restrictive use of invasive ventilation where the decision to intubate was based on the clinical presentation and oxygen content rather than on the degree of hypoxaemia.Method Data analysis was carried out of patients with positive PCR-testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), typical history, and symptoms and pulmonary infiltrates who exhibited oxygen saturation values of <93%.Results We identified 78 patients who met the inclusion criteria. The oxygen saturation nadir was 84.4±6.5% for the whole group. 53 patients (68%) received nasal oxygen (group 1), 17 patients (22%) were treated with nasal high-flow continuous positive airway pressure (CPAP), noninvasive ventilation or a combination thereof (group 2), and eight patients (10%) were intubated (group 3). The Horovitz index was 216±8 for group 1, 157±13 for group 2 and 106±15 for group 3. Oxygen content was 14.5±2.5, 13.4±1.9 and 11.6±2.6 mL O2·dL−1 for the three respective groups. Overall mortality was 7.7%; the mortality of intubated patients was 50%. Overall, 93% of patients could be discharged on room air.Conclusion Permissive hypoxaemia where decisions for the level of respiratory therapy were based on the clinical presentation and oxygen content resulted in low intubation rates, low overall mortality and a low number of patients who require oxygen after discharge.Permissive hypoxaemia where the decision to intubate is based on the clinical picture and oxygen content is feasible in the acute phase of #COVID19 https://bit.ly/35Xj9LO ER -