• Respir Physiol Neurobiol · Sep 2020

    Observational Study

    Non-invasive CPAP in mild and moderate ARDS secondary to SARS-CoV-2.

    • A Pagano, G Porta, G Bosso, E Allegorico, C Serra, F Dello Vicario, V Minerva, T Russo, C Altruda, P Arbo, V Mercurio, and F G Numis.
    • Emergency Department, Santa Maria delle Grazie Hospital Naples, ASL Napoli 2 Nord, Italy. Electronic address: antoniopag82@gmail.com.it.
    • Respir Physiol Neurobiol. 2020 Sep 1; 280: 103489.

    BackgroundDuring the COVID-19 outbreak, a very high number of infected patients developed pneumonia and many of them complicated with acute respiratory distress syndrome. The optimal management of respiratory failure and the role of lung ultrasound imaging in the evaluation of efficacy of treatment are unknown.MethodsIn March 2020 we treated 18 patients with mild and moderate ARDS secondary to SARS-CoV-2 with non-invasive continuous positive airway pressure therapy (NI-CPAP). All patients underwent lung ultrasound imaging to verify the entity of lung recruitment after NI-CPAP initiation.ResultsAfter one hour of treatment we observed a significant improvement in PaO2/FiO2 ratio in 10 patients. Notably, only 50 % of them reached an effective improvement in lung aeration detectable with lung ultrasound. In the other 50 % or patients the improvement in PaO2/FiO2 might be related to blood redistribution and reverse of hypoxic vasoconstriction.ConclusionNI- CPAP is a valid therapeutic option in mild and moderate ARDS secondary SARS-CoV-2. Lung recruitment detected by means of lung ultrasound is a relevant but not the exclusive mechanism that underlies the therapeutic efficacy of NI-CPAP in this clinical setting.Copyright © 2020. Published by Elsevier B.V.

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