Isaac, Barney Thomas Jesudason, Priya, Nadesan, Nair, Avinash Anil, Thangakunam, Balamugesh, Balachandran, Amith, George, Tina, Thomas, Sheba Meriam, George, Tarun Kottukulam, Iyadurai, Ramya, Kumar, Selwyn Selva et al (show 9 more authors)
(2022)
Treatment of COVID-19 Acute Respiratory Distress Syndrome With a Tabletop Noninvasive Ventilation Device in a Respiratory Intermediate Care Unit.
Mayo Clinic proceedings. Innovations, quality & outcomes, 6 (3).
pp. 239-249.
Abstract
<h4>Objective</h4>To study the outcomes of noninvasive ventilation (NIV) administered through a tabletop device for coronavirus disease 2019 acute respiratory distress syndrome in the respiratory intermediate care unit (RIMCU) at a tertiary care hospital in India.<h4>Patients and methods</h4>We retrospectively studied a cohort of hospitalized patients deteriorating despite low-flow oxygen support who received protocolized management with positive airway pressure using a tabletop NIV device in the RIMCU as a step-up rescue therapy from July 30, 2020 to November 14, 2020. Treatment was commenced on the continuous positive airway pressure mode up to a pressure of 10 cm of H<sub>2</sub>O, and if required, inspiratory pressures were added using the bilevel positive air pressure mode. Success was defined as weaning from NIV and stepping down to the ward, and failure was defined as escalation to the intensive care unit, the need for intubation, or death.<h4>Results</h4>In total, 246 patients were treated in the RIMCU during the study period. Of these, 168 received respiratory support via a tabletop NIV device as a step-up rescue therapy. Their mean age was 54 years, and 83% were men. Diabetes mellitus (78%) and hypertension (44%) were the commonest comorbidities. Treatment was successful with tabletop NIV in 77% (129/168) of the patients; of them, 41% (69/168) received treatment with continuous positive airway pressure alone and 36% (60/168) received additional increased inspiratory pressure via the bilevel positive air pressure mode.<h4>Conclusion</h4>Respiratory support using the tabletop NIV device was an effective and economical treatment for coronavirus disease 2019 acute respiratory distress syndrome. Further studies are required to assess the appropriate time of initiation for maximal benefits and judicious utilization of resources.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ARDS, acute respiratory distress syndrome, BPAP, bilevel positive airway pressure, CARDS, coronavirus disease 2019 acute respiratory distress syndrome, COVID-19, coronavirus disease 19, CPAP, continuous positive airway pressure, HFNO, high-flow nasal oxygen, ICU, intensive care unit, IMV, invasive mechanical ventilation, IPAP, inspiratory positive airway pressure, NIV, noninvasive ventilation, PEEP, positive end-expiratory pressure, RIMCU, respiratory intermediate care unit |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 17 Oct 2022 09:24 |
| Last Modified: | 18 Jan 2023 20:36 |
| DOI: | 10.1016/j.mayocpiqo.2022.04.001 |
| Open Access URL: | https://doi.org/10.1016/j.mayocpiqo.2022.04.001 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3165516 |
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