Prolonged non-invasive respiratory supports in a COVID-19 patient with severe acute hypoxemic respiratory failure

Submitted: March 31, 2021
Accepted: July 7, 2021
Published: August 12, 2021
Abstract Views: 1901
PDF: 651
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A pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 was declared in 2020. Severe cases were characterized by the development of acute hypoxemic respiratory failure (AHRF) requiring advanced respiratory support. However, intensive care units (ICU) were saturated, and many patients had to be treated out of ICU. This case describes a 75-year-old man affected by AHRF due to Coronavirus Disease 2019 (COVID-19), hospitalized in a high-dependency unit, with PaO2/FiO2 <100 for 28 consecutive days. An experienced team with respiratory physiotherapists was in charge of the noninvasive ventilatory support (NIVS). The patient required permanent NIVS with continuous positive airway pressure, non-invasive ventilation, high flow nasal oxygen and body positioning. He was weaned from NIVS after 37 days and started exercise training afterwards. The patient was discharged at home with low-flow oxygen therapy. This case represents an example of a successful treatment of AHRF with the still controversial noninvasive respiratory support in one patient with COVID-19.

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Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA 2020;323:1574. DOI: https://doi.org/10.1001/jama.2020.5394
Kangelaris KN, Ware LB, Wang CY, et al. Timing of intubation and clinical outcomes in adults with acute respiratory distress syndrome. Crit Care Med 2016;44:120–9. DOI: https://doi.org/10.1097/CCM.0000000000001359
Bellani G, Laffey JG, Pham T, et al. Noninvasive ventilation of patients with acute respiratory distress syndrome. Insights from the LUNG SAFE study. Am J Respir Crit Care Med 2017;195:67–77. DOI: https://doi.org/10.1164/rccm.201606-1306OC
Tonelli R, Fantini R, Tabbì L, et al. Early Inspiratory effort assessment by esophageal manometry predicts noninvasive ventilation outcome in de novo respiratory failure. A pilot study. Am J Respir Crit Care Med 2020;202:558–67. DOI: https://doi.org/10.1164/rccm.201912-2512OC
Antonelli M, Conti G, Moro M, et al. Predictors of failure of noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure: a multi-center study. Intensive Care Med 2001;27:1718–28. DOI: https://doi.org/10.1007/s00134-001-1114-4
Winck JC, Ambrosino N. COVID-19 pandemic and non invasive respiratory management: Every Goliath needs a David. An evidence based evaluation of problems. Pulmonology 2020;26:213–20. DOI: https://doi.org/10.1016/j.pulmoe.2020.04.013
Vergano M, Bertolini G, Giannini A, et al. Clinical ethics recommendations for the allocation of intensive care treatments in exceptional, resource-limited circumstances: the Italian perspective during the COVID-19 epidemic. Crit Care 2020;24:165. DOI: https://doi.org/10.1186/s13054-020-02891-w
Liu Y-J, Zhao J, Tang H. Non-invasive ventilation in acute respiratory failure: a meta-analysis. Clin Med 2016;16:514–23. DOI: https://doi.org/10.7861/clinmedicine.16-6-514
Brochard L, Slutsky A, Pesenti A. Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med 2017;195:438–42. DOI: https://doi.org/10.1164/rccm.201605-1081CP
Cheung TMT, Yam LYC, So LKY, et al. Effectiveness of noninvasive positive pressure ventilation in the treatment of acute respiratory failure in severe acute respiratory syndrome. Chest 2004;126:845–50. DOI: https://doi.org/10.1378/chest.126.3.845
Belenguer-Muncharaz A, Reig-Valero R, Altaba-Tena S, et al. [Utilización de la ventilación mecánica no invasiva en neumonía grave por virus H1N1].[Article in Spanish]. Med Intensiva 2011;35:470–7. DOI: https://doi.org/10.1016/j.medin.2011.04.001
Mukhtar A, Lotfy A, Hasanin A, El-Hefnawy I, El Adawy A. Outcome of non-invasive ventilation in COVID-19 critically ill patients: A Retrospective observational Study. Anaesth Crit Care Pain Med 2020;39:579–80. DOI: https://doi.org/10.1016/j.accpm.2020.07.012
COVID-ICU Group on behalf of the REVA Network, COVID-ICU Investigators. Clinical characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: a prospective cohort study. Intensive Care Med 2021;47:60–73.
Wilson ME, Majzoub AM, Dobler CC, et al. Noninvasive ventilation in patients with do-not-intubate and comfort-measures-only orders: A systematic review and meta-analysis. Crit Care Med 2018;46:1209–16. DOI: https://doi.org/10.1097/CCM.0000000000003082
Yoshida T, Grieco DL, Brochard L, Fujino Y. Patient self-inflicted lung injury and positive end-expiratory pressure for safe spontaneous breathing. Curr Opin Crit Care 2020;26:59–65. DOI: https://doi.org/10.1097/MCC.0000000000000691
Pb S, Mittal S, Madan K, et al. Awake prone positioning in non-intubated patients for the management of hypoxemia in COVID-19: A systematic review and meta-analysis. Monaldi Arch Chest Dis 2021;91:1623. DOI: https://doi.org/10.4081/monaldi.2021.1623
Lazzeri M, Lanza A, Bellini R, et al. Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a Position Paper of the Italian Association of Respiratory Physiotherapists (ARIR). Monaldi Arch Chest Dis 2020;90:1285. DOI: https://doi.org/10.4081/monaldi.2020.1285
Vitacca M, Lazzeri M, Guffanti E, et al. Italian suggestions for pulmonary rehabilitation in COVID-19 patients recovering from acute respiratory failure: results of a Delphi process. Monaldi Arch Chest Dis 2020;90:1444. DOI: https://doi.org/10.4081/monaldi.2020.1444
Karim HMR, Burns KEA, Ciobanu LD, et al. Noninvasive ventilation: education and training. A narrative analysis and an international consensus document. Adv Respir Med 2019;87:36–45.

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How to Cite

Lanza, Andrea, Maurizio Sommariva, Sara Mariani, Gabriela Ferreyra, Giuliana Enrica Stagni, Valeria Tombini, Angela Oppizzi, Catia Pontiggia, and Andrea Bellone. 2021. “Prolonged Non-Invasive Respiratory Supports in a COVID-19 Patient With Severe Acute Hypoxemic Respiratory Failure”. Monaldi Archives for Chest Disease 92 (1). https://doi.org/10.4081/monaldi.2021.1783.

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