Implementation Science Communications (Aug 2021)

The CircumVent Project: a CPAP/O2 helmet solution for non-invasive ventilation using an implementation research framework

  • Aimalohi A. Ahonkhai,
  • Adesola Z. Musa,
  • André A. Fenton,
  • Muktar H. Aliyu,
  • Igho Ofotokun,
  • Alex Hornstein,
  • Baba M. Musa,
  • Nnamdi Nwosu,
  • Ifeoma Ulasi,
  • Samuel Ajayi,
  • Catherine Falade,
  • Adedamola Dada,
  • Aliyu Abdu,
  • Mogaji Sunday,
  • Adenike Odewabi,
  • Muyiwa K. Rotimi,
  • Onome Ogueh,
  • Alan Steinbach,
  • Gbenga Ogedegbe,
  • Babatunde L. Salako,
  • Oliver C. Ezechi

DOI
https://doi.org/10.1186/s43058-021-00193-y
Journal volume & issue
Vol. 2, no. 1
pp. 1 – 8

Abstract

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Abstract Background Acute respiratory failure, a major cause of death in COVID-19, is managed with high-flow oxygen therapy via invasive mechanical ventilation. In resource-limited settings like Nigeria, the shortage of ventilators and oxygen supply makes this option challenging. Evidence-based non-invasive alternatives to mechanical ventilation such as the use of continuous positive airway pressure (CPAP) devices exist, but there have been concerns that non-invasive ventilation may expose healthcare workers to infection from aerosolized dispersion of SARS-CoV-2. We propose to evaluate the feasibility, adaptability and acceptability of a CPAP/O2 helmet solution for non-invasive ventilation among patients with COVID-19 and health workers in eight COVID-19 treatment and isolation centers in Nigeria. Methods The study will occur in 4 stages: (1) convene a Steering Committee of key stakeholders and recruit implementation sites; (2) use the integrated Promoting Action on Research Implementation in Health Services (i-PARiHS) framework to guide a needs assessment of treatment centers’ capacity to use high-flow oxygen therapy to treat COVID-19 patients and utilize the findings to develop an implementation strategy for the use of a CPAP/O2 helmet solution; (3) build infrastructure to support training and data monitoring processes and to develop implementation protocols to evaluate the adaptability of the strategy for the use of the CPAP/O2 helmet; and (4) train health workers, distribute a CPAP/O2 helmet solution for non-invasive ventilation, pilot test the implementation strategy, and assess feasibility of its use and acceptability that includes monitoring altered risk of SARS-CoV-2 infection among healthcare workers. Discussion The CPAP/O2 helmet solution for non-invasive ventilation in Nigeria can serve as a scalable model for resource-poor countries, and beyond the COVID-19 pandemic, has the potential to be deployed for the treatment of pneumonia and other respiratory diseases. Trial registration NCT04929691. Registered June 18, 2021—retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04929691

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