Late Breaking Abstract - The impact of the use of helmet CPAP in a general ward during COVID-19 outbreak

Abstract

Introduction or background: During COVID-19 outbreak, helmet noninvasive ventilation (hNIV) and helmet continuous positive airway pressure (hCPAP) have been used with the purpose of early supporting patients with acute respiratory distress syndrome (ARDS) considering the frequent lack of Intensive Care Units (ICU) beds. Rimini province is one of the Italian areas more severely affected. In order to face the increasing number of patients needing respiratory support, in our hospital, 11 monitored beds in Infectious Disease Department’s negative pressure rooms have been set up. The management of respiratory failure has been entrusted to the pulmonologists.

Aims and objectives: The aim of the study is to evaluate the effectiveness of early hNIV/hCPAP used to avoid or to safely postpone intubation while waiting for a bed in ICU.

Methods: We evaluated data collected in 59 patients (14 female and 45 male) with COVID-19 related ARDS admitted in Rimini Hospital Infectious Disease Department to be subjected to hCPAP/hNIV. (Table 1).

Results: 36/59 patients (61%) treated with hCPAP survived without intubation. 10 patients were declared do not intubate for comorbidities and received hCPAP as a ceiling treatment, 3/10 survived. 16 patients were intubated (13 in election and 3 for complications), 5/16 died in ICU. To date 47/59 patients (79%) are still alive.

Conclusions: During COVID-19 outbreak hCPAP avoided intubation for 36/59 (61%) patients, for others 8 the intubation was elective and postponed. Thanks to the early use of hCPAP, 36 ICU beds could be used to treat other patients with ARDS.