Your browser doesn't support javascript.
Feasibility of CPAP application and variables related to worsening of respiratory failure in pregnant women with SARS-CoV-2 pneumonia: Experience of a tertiary care centre.
Faverio, Paola; Ornaghi, Sara; Stainer, Anna; Invernizzi, Francesca; Borelli, Mara; Brunetti, Federica; La Milia, Laura; Paolini, Valentina; Rona, Roberto; Foti, Giuseppe; Luppi, Fabrizio; Vergani, Patrizia; Pesci, Alberto.
  • Faverio P; Respiratory Unit, School of Medicine and Surgery, University of Milano Bicocca, San Gerardo Hospital, ASST Monza, Monza, Italy.
  • Ornaghi S; Obstetric Unit, School of Medicine and Surgery, University of Milano Bicocca, MBBM Foundation Onlus at San Gerardo Hospital, Monza, Italy.
  • Stainer A; Respiratory Unit, School of Medicine and Surgery, University of Milano Bicocca, San Gerardo Hospital, ASST Monza, Monza, Italy.
  • Invernizzi F; Obstetric Unit, School of Medicine and Surgery, University of Milano Bicocca, MBBM Foundation Onlus at San Gerardo Hospital, Monza, Italy.
  • Borelli M; Respiratory Unit, School of Medicine and Surgery, University of Milano Bicocca, San Gerardo Hospital, ASST Monza, Monza, Italy.
  • Brunetti F; Department of Obstetrics and Gynaecology, Desio Hospital, ASST Monza, Desio, Italy.
  • La Milia L; Obstetric Unit, School of Medicine and Surgery, University of Milano Bicocca, MBBM Foundation Onlus at San Gerardo Hospital, Monza, Italy.
  • Paolini V; Respiratory Unit, School of Medicine and Surgery, University of Milano Bicocca, San Gerardo Hospital, ASST Monza, Monza, Italy.
  • Rona R; Respiratory Unit, School of Medicine and Surgery, University of Milano Bicocca, San Gerardo Hospital, ASST Monza, Monza, Italy.
  • Foti G; Department of Anesthesia and Intensive Care Medicine, ASST Monza, Monza, Italy.
  • Luppi F; Respiratory Unit, School of Medicine and Surgery, University of Milano Bicocca, San Gerardo Hospital, ASST Monza, Monza, Italy.
  • Vergani P; Department of Anesthesia and Intensive Care Medicine, ASST Monza, Monza, Italy.
  • Pesci A; Respiratory Unit, School of Medicine and Surgery, University of Milano Bicocca, San Gerardo Hospital, ASST Monza, Monza, Italy.
PLoS One ; 16(10): e0258754, 2021.
Article in English | MEDLINE | ID: covidwho-1477539
ABSTRACT
Continuous positive airway pressure (CPAP) has been successfully applied to patients with COVID-19 to prevent endotracheal intubation. However, experience of CPAP application in pregnant women with acute respiratory failure (ARF) due to SARS-CoV-2 pneumonia is scarce. This study aimed to describe the natural history and outcome of ARF in a cohort of pregnant women with SARS-CoV-2 pneumonia, focusing on the feasibility of helmet CPAP (h-CPAP) application and the variables related to ARF worsening. A retrospective, observational study enrolling 41 consecutive pregnant women hospitalised for SARS-CoV-2 pneumonia in a tertiary care center between March 2020 and March 2021. h-CPAP was applied if arterial partial pressure of oxygen to fraction of inspired oxygen ratio (PaO2/FiO2) was inferior to 200 and/or patients had respiratory distress despite adequate oxygen supplementation. Characteristics of patients requiring h-CPAP vs those in room air or oxygen only were compared. Twenty-seven (66%) patients showed hypoxemic ARF requiring oxygen supplementation and h-CPAP was needed in 10 cases (24%). PaO2/FiO2 was significantly improved during h-CPAP application. The device was well-tolerated in all cases with no adverse events. Higher serum C reactive protein and more extensive (≥3 lobes) involvement at chest X-ray upon admission were observed in the h-CPAP group. Assessment of temporal distribution of cases showed a substantially increased rate of CPAP requirement during the third pandemic wave (January-March 2021). In conclusion, h-CPAP was feasible, safe, well-tolerated and improved oxygenation in pregnant women with moderate-to-severe ARF due to SARS-CoV-2 pneumonia. Moderate-to-severe ARF was more frequently observed during the third pandemic wave.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Oxygen / Pregnancy Complications, Infectious / Respiratory Insufficiency / Continuous Positive Airway Pressure / Tertiary Care Centers / SARS-CoV-2 / COVID-19 Type of study: Observational study Limits: Adult / Female / Humans / Pregnancy Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0258754

Full text: Available Collection: International databases Database: MEDLINE Main subject: Oxygen / Pregnancy Complications, Infectious / Respiratory Insufficiency / Continuous Positive Airway Pressure / Tertiary Care Centers / SARS-CoV-2 / COVID-19 Type of study: Observational study Limits: Adult / Female / Humans / Pregnancy Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0258754