https://doi.org/10.4081/ecj.2024.12225

Outcomes of bailout use of continuous positive airway pressure in patients with severe COVID-19 respiratory failure

Vol. 20 No. 2 (2024)
Submitted: 23 December 2023
Accepted: 7 March 2024
Published: 8 April 2024
Emergency department, COVID-19, CPAP, respiratory failure, outcome
Abstract Views: 3153
PDF: 208
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Authors

Alberto Giannone
Emergency department, ASST Papa Giovanni XXIII, Bergamo, Italy.
Isabelle Piazza
Emergency department, ASST Papa Giovanni XXIII, Bergamo; Università degli Studi di Milano, Milan, Italy.
Carlo Preti
Emergency department, ASST Papa Giovanni XXIII, Bergamo; Università degli Studi di Milano, Milan, Italy.
Eleonora Pisano
https://orcid.org/0000-0002-6736-4656
Emergency department, ASST Papa Giovanni XXIII, Bergamo; Università degli Studi di Milano, Milan, Italy.
Arianna Ghirardi
FROM Research foundation, ASST Papa Giovanni XXIII, Bergamo, Italy.
Alberto Benetti
Unit of Internal Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy.
Stefano Fagiuoli
Unit of Gastroenterology, Hepatology and Transplantation, ASST Papa Giovanni XXIII, Bergamo; Gastroenterology, Department of Medicine, University of Milan Bicocca, Italy.
Ferdinando L. Lorini
Intensive Care Unit, ASST Papa Giovanni XXIII, Bergamo, Italy.
Marco Rizzi
https://orcid.org/0000-0002-2081-8542
Unit of Infectious Disease, ASST Papa Giovanni XXIII, Bergamo, Italy.
Fabiano Di Marco
https://orcid.org/0000-0002-1743-0504
Università degli Studi di Milano, Milan; Unit of Pulmonary Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy.
Roberto Cosentini
rcosentini@asst-pg23.it
https://orcid.org/0000-0003-3407-3630
Emergency department, ASST Papa Giovanni XXIII, Bergamo; Gastroenterology, Department of Medicine, University of Milan Bicocca, Italy.

During the first wave of the Coronavirus-19 (COVID-19) pandemic, due to an overflow of patients in the ICU, continuous positive airway pressure (CPAP) was used as a last resort to mechanical ventilation. The purpose of this study is to evaluate prognostic factors in COVID-19 severe respiratory failure patients treated with helmet CPAP. We reviewed the medical records of COVID-19 respiratory failure patients treated with H-CPAP at the Emergency Department from February 23rd to March 14th, 2020. A total of 202 (40%) patients admitted for respiratory failure due to COVID-19 pneumonia were considered. 129 (64%) patients received H-CPAP, while 73 (36%) required endotracheal intubation and invasive mechanical ventilation despite initial H-CPAP. 99 patients (49%) died. The mortality rate in the IMV group was 37%, compared to 56% in the group that received only H-CPAP (p= 0.004). The age and comorbidities of patients in the two groups differed significantly (p < 0.001). Age and PaO2/FiO2 were identified as the only independent risk factors for death. Identifying these independent predictors of mortality in patients with acute respiratory insufficiency may help clinicians optimize treatment escalation.

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How to Cite

Giannone, A., Piazza, I., Preti, C., Pisano, E., Ghirardi, A., Benetti, A., Fagiuoli, S., Lorini, F. L., Rizzi, M., Di Marco, F., & Cosentini, R. (2024). Outcomes of bailout use of continuous positive airway pressure in patients with severe COVID-19 respiratory failure. Emergency Care Journal, 20(2). https://doi.org/10.4081/ecj.2024.12225
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