دورية أكاديمية
Continuous positive airway pressure for respiratory support during COVID-19 pandemic: a frugal approach from bench to bedside
| العنوان: | Continuous positive airway pressure for respiratory support during COVID-19 pandemic: a frugal approach from bench to bedside |
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| المؤلفون: | CARTEAUX, Guillaume, PONS, Manuella, MORIN, François, TUFFET, Samuel, LESIMPLE, Arnaud, BADAT, Bilal, HAUDEBOURG, Anne-Fleur, PERIER, Francois, DEPLANTE, Yvon, GUILLAUD, Constance, SCHLEMMER, Frédéric, FOIS, Elena, MONGARDON, Nicolas, KHELLAF, Mehdi, JAFFAL, Karim, DEGUILLARD, Camille, GRIMBERT, Philippe, HUGUET, Raphaelle, RAZAZI, Keyvan, DE PROST, Nicolas, TEMPLIER, François, BELONCLE, Francois, MERCAT, Alain, BROCHARD, Laurent, AUDARD, Vincent, LIM, Pascal, RICHARD, Jean-Christophe, SAVARY, Dominique, MEKONTSO DESSAP, Armand |
| بيانات النشر: | SpringerOpen |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | COVID-19, Acute hypoxemic respiratory failure, Continuous positive airway pressure, Frugal innovation, Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Pneumologie et système respiratoire, Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Maladies infectieuses, Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Maladies émergentes |
| الوصف: | Background We describe a frugal approach (focusing on needs, performance, and costs) to manage a massive influx of COVID-19 patients with acute hypoxemic respiratory failure (AHRF) using the Boussignac valve protected by a filter ("Filter Frugal CPAP", FF-CPAP) in and out the ICU.Methods (1) A bench study measured the impact of two filters with different mechanical properties on CPAP performances, and pressures were also measured in patients. (2) Non-ICU healthcare staff working in COVID-19 intermediate care units were trained with a video tutorial posted on a massive open online course. (3) A clinical study assessed the feasibility and safety of using FF-CPAP to maintain oxygenation and manage patients out of the ICU during a massive outbreak.Results: Bench assessments showed that adding a filter did not affect the effective pressure delivered to the patient. The resistive load induced by the filter variably increased the simulated patient's work of breathing (6-34%) needed to sustain the tidal volume, depending on the filter's resistance, respiratory mechanics and basal inspiratory effort. In patients, FF-CPAP achieved pressures similar to those obtained on the bench. The massive training tool provided precious information on the use of Boussignac FF-CPAP on COVID-19 patients. Then 85 COVID-19 patients with ICU admission criteria over a 1-month period were studied upon FF-CPAP initiation for AHRF. FF-CPAP significantly decreased respiratory rate and increased SpO(2). Thirty-six (43%) patients presented with respiratory indications for intubation prior to FF-CPAP initiation, and 13 (36%) of them improved without intubation. Overall, 31 patients (36%) improved with FF-CPAP alone and 17 patients (20%) did not require ICU admission. Patients with a respiratory rate > 32 breaths/min upon FF-CPAP initiation had a higher cumulative probability of intubation (p < 0.001 by log-rank test).Conclusion: Adding a filter to the Boussignac valve does not affect the delivered pressure but may variably increase the ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 2110-5820 |
| العلاقة: | https://oskar-bordeaux.fr/handle/20.500.12278/33434Test |
| DOI: | 10.1186/s13613-021-00828-2 |
| الإتاحة: | https://doi.org/20.500.12278/33434Test https://doi.org/10.1186/s13613-021-00828-2Test https://oskar-bordeaux.fr/handle/20.500.12278/33434Test https://hdl.handle.net/20.500.12278/33434Test |
| حقوق: | http://creativecommons.org/licenses/byTest/ |
| رقم الانضمام: | edsbas.EBC4145D |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 21105820 |
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| DOI: | 10.1186/s13613-021-00828-2 |