RT Journal Article
SR Electronic
T1 Outcomes and characteristics of COVID-19 patients treated with continuous positive airway pressure/high-flow nasal oxygen outside the intensive care setting
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00318-2021
DO 10.1183/23120541.00318-2021
VO 7
IS 4
A1 Dominic L. Sykes
A1 Michael G. Crooks
A1 Khaing Thu Thu
A1 Oliver I. Brown
A1 Theodore J.P. Tyrer
A1 Jodie Rennardson
A1 Catherine Littlefield
A1 Shoaib Faruqi
YR 2021
UL http://openres.ersjournals.com/content/7/4/00318-2021.abstract
AB Background Continuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO) have been used to manage hypoxaemic respiratory failure secondary to coronavirus disease 2019 (COVID-19) pneumonia. Limited data are available for patients treated with noninvasive respiratory support outside of the intensive care setting.Methods In this single-centre observational study we observed the characteristics, physiological observations, laboratory tests and outcomes of all consecutive patients with COVID-19 pneumonia between April 2020 and March 2021 treated with noninvasive respiratory support outside of the intensive care setting.Results We report the outcomes of 140 patients (mean±sd age: 71.2±11.1, 65% male (n=91)) treated with CPAP/HFNO outside of the intensive care setting. Overall mortality was 59% and was higher in those deemed unsuitable for mechanical ventilation (72%). The mean age of survivors was significantly lower than those who died (66.1 versus 74.4 years, p<0.001). Those who survived their admission also had a significantly lower median Clinical Frailty Score than the non-survivor group (2 versus 4, p<0.001). We report no significant difference in mortality between those treated with CPAP (n=92, mortality: 60%) or HFNO (n=48, mortality: 56%). Treatment was well tolerated in 86% of patients receiving either CPAP or HFNO.Conclusions CPAP and HFNO delivered outside of the intensive care setting are viable treatment options for patients with hypoxaemic respiratory failure secondary to COVID-19 pneumonia, including those considered unsuitable for invasive mechanical ventilation. This provides an opportunity to safeguard intensive care capacity for COVID-19 patients requiring invasive mechanical ventilation.CPAP and HFNO are viable treatment options for hypoxaemic respiratory failure secondary to COVID-19, including in those unsuitable for invasive ventilation. These data show that these patients can be safely and effectively managed outside the ICU. https://bit.ly/36qdJsx