Nursing evaluation during treatment with helmet continuous positive airway pressure in patients with respiratory failure due to COVID-19 pneumonia: A case series

PRIVITERA, Daniele; Capsoni, Nicolò; Mazzone, Annamaria; Airoldi, Chiara; Angaroni, Laura; Pierotti, Federico; Rocca, Eugenia; Dal Molin, Alberto; Bellone, Andrea

doi:10.1016/j.aucc.2021.10.001

Article (Scientific journals)

Nursing evaluation during treatment with helmet continuous positive airway pressure in patients with respiratory failure due to COVID-19 pneumonia: A case series

PRIVITERA, Daniele; Capsoni, Nicolò; Mazzone, Annamaria et al.

2022 • In Australian Critical Care, 35 (1), p. 46 - 51

Peer Reviewed verified by ORBi

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https://hdl.handle.net/10993/66509

DOI
10.1016/j.aucc.2021.10.001

PubMed
34802843

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Keywords :

Continuous positive airway pressure; COVID-19; Emergency department; Hypoxemic respiratory failure; Noninvasive ventilation; Nursing care; Adult; Continuous Positive Airway Pressure; Head Protective Devices; Humans; Respiratory Insufficiency; SARS-CoV-2; adult; helmet; human; positive end expiratory pressure ventilation; respiratory failure

Abstract :

[en] Background: During COVID-19 outbreak, with the increasing number of patients presenting with acute respiratory failure, a large use of non invasive positive pressure ventilation was done in the emergency departments and medical wards despite the lack of recommendations. Objectives: This study describes the clinical characteristics of patients presenting to the hospital with acute respiratory failure due to COVID-19 related pneumonia undergoing treatment with helmet continuous positive airway pressure (CPAP) with a strict nursing evaluation and monitoring. Methods: A case series study enrolling adult patients admitted to an emergency department of an Italian hospital with acute respiratory failure due to COVID-19 pneumonia from March 18th to April 18th, 2020, was conducted. Only patients who strictly followed a local CPAP protocol were enrolled. Results: A total of 52 patients were included in this study. Thirty-eight patients (73%) were judged eligible for endotracheal intubation (ETI). Eighteen (34.6%) were intubated. Sixteen (30.8%) patients died: seven (38.9%) and nine (26.5%) in the eligible-for-ETI and non eligible-for-ETI group, respectively. The median hospital length of stay was different in the ETI and non-ETI group: 26 days (interquartile range [IQR]: 16–37) vs 15 days [IQR 9–17] (p = 0.005). The median invasive mechanical ventilation time was 11 days [IQR 7–21] with an ICU length of stay of 14.5 days [IQR 10–28]. During the CPAP trial, among patients eligible for ETI variations over time for positive end-expiratory pressure (p = 0.003) and respiratory rate (p = 0.059) were found between intubated and non-intubated patients. Conclusions: A short closed monitored CPAP trial could be considered for acute respiratory failure due to COVID-19 pneumonia before considering ETI. A progressive positive end-expiratory pressure titration should target reduction in a patient's respiratory rate. More studies are needed to evaluate the efficacy and predictors of failure of CPAP and non-invasive positive pressure ventilation in patients with acute respiratory failure due to COVID-19 pneumonia. © 2021 Australian College of Critical Care Nurses Ltd

Disciplines :

Nursing Science

Author, co-author :

PRIVITERA, Daniele ; University of Luxembourg > Faculty of Science, Technology and Medicine (FSTM) > Department of Life Sciences and Medicine (DLSM) > Medical Education ; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

Capsoni, Nicolò; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

Mazzone, Annamaria; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

Airoldi, Chiara; Department of Translation Medicine, University of Piemonte Orientale, Novara, Italy

Angaroni, Laura; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

Pierotti, Federico; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

Rocca, Eugenia; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

Dal Molin, Alberto; Department of Translation Medicine, University of Piemonte Orientale, Novara, Italy ; Health Professions' Direction, Maggiore Della Carità Hospital, Novara, Italy

Bellone, Andrea; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

External co-authors :

Language :

English

Title :

Nursing evaluation during treatment with helmet continuous positive airway pressure in patients with respiratory failure due to COVID-19 pneumonia: A case series

Publication date :

2022

Journal title :

Australian Critical Care

ISSN :

1036-7314

eISSN :

1878-1721

Publisher :

Elsevier Ireland Ltd

Volume :

Issue :

Pages :

46 - 51

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBilu :

since 26 November 2025

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