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HGNC Genes

SARS-CoV-2 proteins

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    Helmet CPAP HGNC to treat hypoxic pneumonia MESHD outside the ICU: an observational study during the COVID-19 MESHD outbreak

    Authors: Andrea Coppadoro; Annalisa Benini; Robert Fruscio; Luisa Verga; Paolo Mazzola; Giuseppe Bellelli; Marco Carbone; Giacomo Mulinacci; Alessandro Soria; Beatrice Noe'; Eduardo Beck; Riccardo Di Sciacca; Davide Ippolito; Giuseppe Citerio; Grazia Valsecchi; Andrea Biondi; Alberto Pesci; Paolo Bonfanti; Davide Gaudesi; Giacomo Bellani; Giuseppe Foti

    doi:10.21203/rs.3.rs-92708/v2 Date: 2020-10-14 Source: ResearchSquare

    Background: Respiratory failure MESHD due to COVID-19 MESHD pneumonia MESHD is associated with high mortality and may overwhelm health care systems, due to the surge patients requiring advanced respiratory support. Shortage of intensive care unit (ICU) beds required many patients to be treated outside the ICU despite severe gas exchange impairment MESHD. Helmet is as effective interface to provide Continuous Positive Airway Pressure ( CPAP HGNC) non-invasively. We report data about the usefulness of helmet CPAP HGNC during pandemic, either as an effective treatment, a bridge to intubation or a rescue therapy for patients with care limitations (DNI).Methods: In this observational study we collected data regarding patients failing standard oxygen therapy (i.e. non-rebreathing mask) due to COVID-19 MESHD pneumonia MESHD treated with a free flow helmet CPAP HGNC system. Patients’ data were recorded before, at initiation of CPAP HGNC treatment and once a day, thereafter. CPAP HGNC failure was defined as a composite outcome of intubation or death MESHD.Results: A total of 306 patients were included; 42% were deemed as DNI. Helmet CPAP HGNC treatment was successful in 69% of the full-treatment and 28% of the DNI patients (P<0.001). With helmet CPAP HGNC, PaO2/FiO2 ratio doubled from about 100 to 200 mmHg (P<0.001); respiratory rate decreased from 28 [22-32] to 24 [20-29] breaths per minute, P<0.001). C-Reactive Protein HGNC, time to oxygen mask failure MESHD, age, PaO2/FiO2 during CPAP HGNC, number of comorbidities were independently associated with CPAP HGNC failure. Helmet CPAP HGNC was maintained for 6 [3-9] days, almost continuously during the first two days. None of the full treatment patients died before intubation in the wards.Conclusions: Helmet CPAP HGNC treatment is feasible for several days outside the ICU, despite persistent impairment in gas exchange. It was used, without escalating to intubation, in the majority of full treatment patients after standard oxygen therapy failed. DNI patients could benefit from helmet CPAP HGNC as rescue therapy to improve survival.Trial Registration: NCT04424992

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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