Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

COVID-19 and acute respiratory failure treated with CPAP

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Danish translation and linguistic validation of the multidimensional dyspnea profile

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Fractional exhaled nitric oxide as a determinant for the clinical course of asthma: a systematic review

    Research output: Contribution to journalReviewResearchpeer-review

  3. The Danish severe asthma register: an electronic platform for severe asthma management and research

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Automatic oxygen titration with O2matic® to patients admitted with COVID-19 and hypoxemic respiratory failure

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Disease self-management in patients with moderate COPD: a thematic analysis

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

Introduction: Patients admitted with COVID-19 often have severe hypoxemic respiratory insufficiency and it can be difficult to maintain adequate oxygenation with oxygen supplementation alone. There is a physiological rationale for the use of Continuous Positive Airway Pressure (CPAP), and CPAP could keep some patients off mechanical ventilation. We aimed to examine the physiological response to CPAP and the outcome of this treatment. Methods: Data from all patients admitted with COVID-19 and treated with CPAP, from March to July 2020 were collected retrospectively. CPAP was initiated on a medical ward when oxygen supplementation exceeded 10 liters/min to maintain oxygen saturation (SpO2) ≥92%. CPAP was administered with full face masks on a continuous basis until stable improvement in oxygenation or until intubation or death. Results: CPAP was initiated in 53 patients (35 men, 18 women) with a median (IQR) age of 68 (57-78) years. Nine patients were not able to tolerate the CPAP treatment. Median duration for the 44 patients receiving CPAP was 3 (2-6) days. The PaO2/FiO2 ratio was severely reduced to an average of 101 mmHg at initiation of treatment. A positive response of CPAP was seen on respiratory rate (p = 0.002) and on oxygenation (p < 0.001). Of the 44 patients receiving CPAP, 12 (27%) avoided intubation,13 (29%) were intubated, and 19 (43%) died. Of the patients with a ceiling of treatment in the ward (26 of 53) only 2 survived. Older age and high initial oxygen demand predicted treatment failure. Discussion: CPAP seems to have positive effect on oxygenation and respiratory rate in most patients with severe respiratory failure caused by COVID-19. Treatment with CPAP to severely hypoxemic patients in a medical ward is possible, but the prognosis for especially elderly patients with high oxygen requirement and with a ceiling of treatment in the ward is poor.

Original languageEnglish
Article number1910191
JournalEuropean Clinical Respiratory Journal
Volume8
Issue number1
Pages (from-to)1-9
Number of pages9
ISSN2001-8525
DOIs
Publication statusPublished - 11 Apr 2021

Bibliographical note

Publisher Copyright:
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

    Research areas

  • Continuous positive airway pressure, Coronavirus disease, Physiotherapy, hypoxemia, noninvasive ventilation

ID: 65426741