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Use of threshold PEP with an adult non-rebreather oxygen mask plus prone positioning in acute hypoxemic respiratory failure due to SARS-CoV-2 infection during the collapse of the health system in a low-income country

During the coronavirus disease 2019 pandemic, Ecuador reported a collapse of the healthcare system, in which intensive care unit beds were lacking. Therefore, we sought to determine whether the use of threshold expiratory positive pressure with an adult non-rebreather oxygen mask plus prone position...

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Detalles Bibliográficos
Autores principales: Briones-Claudett, Killen H, Briones-Claudett, Monica H, Martinez Armijos, Eduardo A, Rios-Marcillo, Jorge J, Orozco Holguin, Lourdes A, Briones-Zamora, Killen H, Briones-Marquez, Diana C, Icaza-Freire, Andrea P, Grunauer, Michelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9936171/
https://www.ncbi.nlm.nih.gov/pubmed/36816823
http://dx.doi.org/10.1177/2050313X231154064
Descripción
Sumario:During the coronavirus disease 2019 pandemic, Ecuador reported a collapse of the healthcare system, in which intensive care unit beds were lacking. Therefore, we sought to determine whether the use of threshold expiratory positive pressure with an adult non-rebreather oxygen mask plus prone positioning is useful for improving oxygenation. Twelve patients were included. Eight patients (66.7%) survived, while four patients (33.3%) died. Baseline arterial oxygen saturation (%) prior placement median (interquartile range) 85.5% (80%–89%) and arterial oxygen saturation (%) post placement of the device was median (interquartile range) (93%–96%) (P = 0.0001). Respiratory rate before placement was median (interquartile range) 38 (36–42) and post placement of the device was median (interquartile range) 24 (22–30) (P = 0.0005). The use of an adapted device might be useful for the management of acute hypoxemic respiratory failure due to severe acute respiratory syndrome coronavirus 2 pneumonia, particularly when mechanical ventilators and high-flow oxygen systems are unavailable.