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  • 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

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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
  1. Rebecca Nightingale1,2,
  2. Nneka Nwosu2,
  3. Farheen Kutubudin2,
  4. Tom Fletcher1,2,
  5. Joe Lewis1,2,3,
  6. Frederick Frost2,3,
  7. Kathryn Haigh2,
  8. Ryan Robinson1,2,
  9. Ayesha Kumar2,
  10. Gareth Jones2,
  11. Deborah Brown2,
  12. Michael Abouyannis1,2,3,
  13. Mike Beadsworth1,2,
  14. Peter Hampshire2,
  15. Stephen Aston2,3,
  16. Manish Gautam2 and
  17. Hassan Burhan2
  1. 1Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
  2. 2Department of Respiratory Medicine, Tropical and Infectious Disease Unit, Intensive Care Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
  3. 3Institute of Infection and Global Health, University of Liverpool, Liverpool, Merseyside, UK
  1. Correspondence to Mrs Rebecca Nightingale; rebecca.nightingale{at}lstmed.ac.uk

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.

  • respiratory Infection
  • non invasive ventilation
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjresp-2020-000639

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    Footnotes

    • RN and NN are joint first authors.

    • Contributors Design and service setup: RN, NN, TF, GJ, DB, MA, MB, PH, SA, MG and HB. Acquisition of data: RN, FK, JL, FF, KH, RR and AK. Analysis: RN, FK,JL and HB. Interpretation: RN, TF, GJ, MA, MB, PH, SA, MG and HB. Significant draft contribution: All authors. Approval of final version and accountable for all aspects of the work: All authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information