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Proposal for Coronavirus Disease 2019 Management.
John B Downs1,2, Barry Weled3, Jukka Räsänen4
1Departments of Anesthesiology and Critical Care Medicine, University of Florida College of Medicine, Gainesville, FL.
Critical Care Explorations
|July 17, 2020
Summary
Early use of facemask continuous positive airway pressure (CPAP) for COVID-19 patients may reduce the need for mechanical ventilators. This approach conserves resources and protects healthcare workers during pandemics.
Area of Science:
- Critical Care Medicine
- Infectious Disease Epidemiology
- Respiratory Medicine
Background:
- The coronavirus disease 2019 (COVID-19) pandemic created widespread fear and predictions of critical resource shortages, including ventilators.
- Patients with COVID-19 often present with early respiratory distress and hypoxemia, but typically not hypercapnia.
Purpose of the Study:
- To evaluate the efficacy of non-invasive ventilation strategies in managing COVID-19 patients.
- To determine if early intervention with continuous positive airway pressure (CPAP) can prevent the need for mechanical ventilation.
- To assess the impact of CPAP on protecting healthcare workers from viral transmission.
Main Methods:
- Utilized facemask continuous positive airway pressure (CPAP) as an intervention for patients with COVID-19 experiencing respiratory distress.
- Applied CPAP protocols designed to maintain adequate alveolar ventilation, normocapnia, and oxygenation.
- Implemented safety protocols to protect healthcare providers from aerosolized infectious particles.
Main Results:
- Facemask CPAP, when applied early and titrated effectively, demonstrated potential to avoid tracheal intubation in COVID-19 patients.
- The use of CPAP facilitated spontaneous ventilation, reducing the need for sedatives and paralytics.
- Protocols were successful in preventing viral transmission to caregivers.
Conclusions:
- Early application of facemask CPAP is a viable strategy to conserve mechanical ventilators during pandemics.
- This non-invasive approach optimizes resource allocation and protects healthcare personnel.
- CPAP allows for spontaneous breathing, potentially decreasing the demand for specialized staff and intensive care unit resources.
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