ABSTRACT
The use of non-invasive respiratory support in the context of the COVID-19 pandemic is controversial. The aim of this observational study was to show the experience of the first month since the creation of a Non-invasive Ventilatory Support Unit (NIVSU) at Hospital Fernandez. We describe the creation of the NIVSU, the health professional-patient ratio, the type of room, the modified personal protection equipment;diagnostic, monitoring and ventilatory support equipment for treatment, as well as the inclusion criteria and the treatment algorithm. Twenty five (63%) of patients were referred from the Internal Medicine Ward, 10 (25%) from Shock Room, and 5 (13%) from Emergency Ward. National Early Warning Score, Acute Physiology and Chronic Health Disease Classification System II and Sequential Organ Failure Assessment, were calculated on admission, with a median of 12, 8, and 2 points, respectively. The Lung Ultrasonography Score was taken to quantify lung ultrasound findings. All patients were admitted with a reservoir mask, 80% inspired O2 fraction was estimated for the calculation of arterial O2 pressure/inspired O2 fraction ratio (Pa/FiO2) at admission. The median of time elapsed from the onset of symptoms referred by the patient to UNIT admission was 13 days. The development of NIVSU prevented a large proportion of patients from being transferred to Intensive Care Unit (ICU) and it could be beneficial in preserving ICUs capacity. These early results suggest that non-invasive treatment may be beneficial for the treatment of severe acute respiratory failure by COVID-19.