Effectiveness of Non-Invasive Ventilation with Awake Prone in Covid-19 Related-Acute Respiratory Distress Syndrome at Covid-19 Isolation Hospital Muzaffarabad

ABSTRACT

Background: Despite its widespread usage, invasive positive pressure ventilation (IPPV) has a dismal track record in COVID-19 patients with SARDS. Currently, there is a paucity of evidence supporting the usefulness of noninvasive positive pressure ventilation (NIPPV) in the treatment of severe ARDS, as well as a significant risk of aerosol formation in patients with COVID-19 infection. Objective(s) This study aims to assess the efficacy and safety of NIPPV administration to COVID-19 patients. Method(s) The trial included 130 participants with moderate tosevere ARDS based to the Berlin criteria (PaO2/FiO2 ratio of 200mmHg, GCS > 13, respiratory breathing index (RBI) of 105, and no systemic issues). They were treated with NIPPV with awake proaning up to 12 hours per day at a hospital in Muzaffarabad. The addition of a heat and moisture exchanger (HME) and viral/bacterial filters to the expiratory limb of the ventilator circuit represented a minor improvement. Result(s) In an average of six days, the PaO2/FiO2 ratio indicates that the severity of ARDS has improved from moderate/severe to mild in 64 percent of patients. 36 percent of individuals who had a defined airway experienced IPPV or failure of NIV. During the study period, 1 % the of healthcare workers (HCW) were infected with COVID19. The delivery of NIPPV was associated with claustrophobia, nasal crusting, aspiration, and barotrauma (0.7 percent). Conclusion(s) In selected patients, NIV with awake proaning up to 12 hours per day can be employed to give respiratory support without the need for IPPV, hence eliminating the need for IPPV in those patients. However, larger-scale investigations are required to validate our findings. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.