Dataset Information

Effectiveness and safety of a new helmet CPAP configuration allowing tidal volume monitoring in patients with COVID-19.

ABSTRACT:

Background

High generated tidal volumes (V_t) have been correlated with higher risk of self-induced lung injury and worse clinical outcome. This study aimed to evaluate the effectiveness and safety of a new helmet continuous positive airway pressure delivered (h-CPAP) configuration allowing V_t monitoring in patients affected by COVID-19.

Methods

This prospective observational study was performed in the respiratory intermediate care unit of University Hospital in Turin, Italy, between March 24th, and June 15th, 2020. Included patients were treated with CPAP via a single-limb intentional leak configuration by a turbine-driven ventilator, provided with a dedicated patch. Effectiveness and safety of the configuration and healthcare workers safety were the outcomes of the study.

Main findings

Thirty-five patients were included in this study. Median age was 67 years (IQR 57-76 years), and 30 patients (85.7%) were men. Median value of overall leaks (intentional plus unintentional) was 68 L/min (IQR 63-75). Reliability of V_t measurements was 100%. An out of scale of V_t (above 50% compared to the previous values) was never recorded. Six patients (17.1%) needed more than two helmet replacements, due to leak test >10 l/min. Arm oedema and skin breakdowns were reported in sixteen (45.7%) and seven (20%) patients respectively. Among the 63 healthcare workers involved in the care of COVID-19 patients during the study only one was positive at RT-PCR nasopharyngeal swab testing.

Conclusions

The use of h-CPAP for treating COVID-19 in this configuration allowed for reliable V_t monitoring. Further studies evaluating this configuration in larger patients' cohorts are needed.

SUBMITTER: Chiappero C

PROVIDER: S-EPMC8266523 | biostudies-literature |

REPOSITORIES: biostudies-literature

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