Is continuous positive airway pressure (CPAP) a new standard of care for type 1 respiratory failure in COVID-19 patients? A retrospective observational study of a dedicated COVID-19 CPAP service

Rebecca Nightingale, Nneka Nwosu, Farheen Kutubudin, Tom Fletcher, Joe Lewis, Frederick Frost, Kathryn Haigh, Ryan Robinson, Ayesha Kumar, Gareth Jones, Deborah Brown, Michael Abouyannis, Mike Beadsworth, Peter Hampshire, Stephen Aston, Manish Gautam, Hassan Burhan, Rebecca Nightingale, Nneka Nwosu, Farheen Kutubudin, Tom Fletcher, Joe Lewis, Frederick Frost, Kathryn Haigh, Ryan Robinson, Ayesha Kumar, Gareth Jones, Deborah Brown, Michael Abouyannis, Mike Beadsworth, Peter Hampshire, Stephen Aston, Manish Gautam, Hassan Burhan

Abstract

The aim of this case series is to describe and evaluate our experience of continuous positive airway pressure (CPAP) to treat type 1 respiratory failure in patients with COVID-19. CPAP was delivered in negative pressure rooms in the newly repurposed infectious disease unit. We report a cohort of 24 patients with type 1 respiratory failure and COVID-19 admitted to the Royal Liverpool Hospital between 1 April and 30 April 2020. Overall, our results were positive; we were able to safely administer CPAP outside the walls of a critical care or high dependency unit environment and over half of patients (58%) avoided mechanical ventilation and a total of 19 out of 24 (79%) have survived and been discharged from our care.

Keywords: non invasive ventilation; respiratory Infection.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

References

    1. Centers for Disease C Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19), 2020. Available: [Accessed 4thMay 2020].
    1. Li HC, Ma J, Zhang H, et al. . [Thoughts and practice on the treatment of severe and critical new coronavirus pneumonia]. Zhonghua Jie He He Hu Xi Za Zhi 2020;43:396–400. 10.3760/cma.j.cn112147-20200312-00320
    1. Ñamendys-Silva SA. Respiratory support for patients with COVID-19 infection. Lancet Respir Med 2020;8:e18. 10.1016/S2213-2600(20)30110-7
    1. Harari SA VM, Blasi F, Centanni S, et al. . Managing the respiratory care of patients with COVID-19: Italian thoracic Society, (AIPO), Italian respiratory Society (SIP), 2020. Available: [Accessed 4th May 2020].
    1. Nicola M, O'Neill N, Sohrabi C, et al. . Evidence based management guideline for the COVID-19 pandemic - Review article. Int J Surg 2020;77:206–16. 10.1016/j.ijsu.2020.04.001
    1. Anaesthesioloigsts WFoSo Coronavirus - guidance for anaesthesia and perioperative care providers, 2020. Available: [Accessed 1st May 2020].
    1. WHO Clinical management of severe acute respiratory infection when COVID-19 is suspected, 2020. Available: [Accessed 1st May 2020].
    1. NHS England Guidance for the role and use of non-invasive respiratory support in adult patients with COVID19 (confirmed or suspected), 2020. Available: [Accessed 4thMay 2020].
    1. RECOVERY-RS Respiratory Support : Respiratory Strategies in COVID-19; CPAP, High-flow, and standard care. Available: [Accessed 16th Jun 2020].

Source: PubMed

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