• Giuseppe A Ramirez, Enrica P Bozzolo, Elena Castelli, Alessandro Marinosci, Piera Angelillo, Sarah Damanti, Raffaella Scotti, Agnese Gobbi, Clarissa Centurioni, Flavia DI Scala, Anna Morgillo, Antonella Castagna, Caterina Conte, Andrea Assanelli, Francesco DE Cobelli, Barbara Calcaterra, Luca Cabrini, Francesco Carcò, Stefano Turi, Paolo Silvani, Lorenzo Dagna, Alberto Zangrillo, Giovanni Landoni, Moreno Tresoldi, and Covid-19 BioB Study Group.
• Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy.
• Minerva Med. 2022 Apr 1; 113 (2): 281-290.

BackgroundThe efficacy and safety of continuous positive airway pressure and respiratory physiotherapy outside the Intensive Care Unit during a pandemic.MethodsIn this cohort study performed in February-May 2020 in a large teaching hospital in Milan, COVID-19 patients with adult respiratory distress syndrome receiving continuous positive airway pressure (positive end-expiratory pressure =10 cm H2O, FiO2=0.6, daily treatment duration: 4×3h-cycles) and respiratory physiotherapy including pronation outside the Intensive Care Unit were followed-up.ResultsOf 90 acute respiratory distress syndrome (ARDS) patients treated with continuous positive airway pressure (45/90, 50% pronated at least once) outside the Intensive Care Unit and with a median (interquartile) follow-up of 37 (11-46) days, 45 (50%) were discharged at home, 28 (31%) were still hospitalized, and 17 (19%) died. Continuous positive airway pressure failure was recorded for 35 (39%) patients. Patient mobilization was associated with reduced failure rates (P=0.033). No safety issues were observed.ConclusionsContinuous positive airway pressure with patient mobilization (including pronation) was effective and safe in patients with ARDS due to COVID-19 managed outside the Intensive Care Unit setting during the pandemic.

11 keywords...

hide…