Journal of International Medical Research (Jan 2024)

Efficiency of continuous positive airway pressure and high-flow nasal oxygen therapy in critically ill patients with COVID-19

  • Corina Manole,
  • Mihaela Dediu-Anghel,
  • Liliana Baroiu,
  • Ioana Anca Ștefanopol,
  • Alexandru Nechifor,
  • Elena Niculet,
  • Raul Mihailov,
  • Lavinia Alexandra Moroianu,
  • Doina Carina Voinescu,
  • Dorel Firescu

DOI
https://doi.org/10.1177/03000605231222151
Journal volume & issue
Vol. 52

Abstract

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Objective Critically ill patients with COVID-19 develop acute respiratory distress syndrome characterized by relatively well-preserved pulmonary compliance but severe hypoxemia. The challenge in managing such patients lies in optimizing oxygenation, which can be achieved through either high oxygen flow or noninvasive mechanical ventilation. This study was performed to compare the efficiency of two methods of noninvasive oxygen therapy: continuous positive airway pressure (CPAP) and high-flow nasal oxygen therapy (HFNO). Methods This retrospective cohort study involved 668 patients hospitalized in the intensive care unit (ICU) of the “Sf. Apostol Andrei” Emergency Clinical Hospital, Galati, Romania from 1 April 2020 to 31 March 2021 (CPAP, n = 108; HFNO, n = 108). Results Mortality was significantly lower in the CPAP and HFNO groups than in the group of patients who underwent intubation and mechanical ventilation after ICU admission. Mortality in the ICU was not significantly different between the CPAP and HFNO groups. Conclusions HFNO and CPAP represent efficient alternative therapies for patients with severe COVID-19 whose respiratory treatment has failed. Studies involving larger groups of patients are necessary to establish a personalized, more complex management modality for critically ill patients with COVID-19.