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Volume 9
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10.3390/jcm9041191
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Perspective

Helmet CPAP to Treat Acute Hypoxemic Respiratory Failure in Patients with COVID-19: A Management Strategy Proposal

by
Dejan Radovanovic
1,
Maurizio Rizzi
1,
Stefano Pini
1,
Marina Saad
1,
Davide Alberto Chiumello
2,3 and
Pierachille Santus
1,*
1
Department of Biomedical and Clinical Sciences (DIBIC), Division of Respiratory Diseases, Università degli Studi di Milano, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, Via G.B. Grassi, 74-20157 Milano, Italy
2
SC Anestesia e Rianimazione, Ospedale San Paolo-Polo Universitario, ASST Santi Paolo e Carlo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Via Antonio di Rudinì, 8-20142 Milano, Italy
3
Centro Ricerca Coordinata di Insufficienza Respiratoria, 20123 Milano, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(4), 1191; https://doi.org/10.3390/jcm9041191
Submission received: 27 March 2020 / Revised: 10 April 2020 / Accepted: 20 April 2020 / Published: 22 April 2020
(This article belongs to the Section Respiratory Medicine)
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Abstract

Since the beginning of March 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused more than 13,000 deaths in Europe, almost 54% of which has occurred in Italy. The Italian healthcare system is experiencing a stressful burden, especially in terms of intensive care assistance. In fact, the main clinical manifestation of COVID-19 patients is represented by an acute hypoxic respiratory failure secondary to bilateral pulmonary infiltrates, that in many cases, results in an acute respiratory distress syndrome and requires an invasive ventilator support. A precocious respiratory support with non-invasive ventilation or high flow oxygen should be avoided to limit the droplets’ air-dispersion and the healthcare workers’ contamination. The application of a continuous positive airway pressure (CPAP) by means of a helmet can represent an effective alternative to recruit diseased alveolar units and improve hypoxemia. It can also limit the room contamination, improve comfort for the patients, and allow for better clinical assistance with long-term tolerability. However, the initiation of a CPAP is not free from pitfalls. It requires a careful titration and monitoring to avoid a delayed intubation. Here, we discuss the rationale and some important considerations about timing, criteria, and monitoring requirements for patients with COVID-19 respiratory failure requiring a CPAP treatment.
Keywords: continuous positive airway pressure; positive end-expiratory pressure; COVID-19; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); respiratory failure; helmet; hypoxia; pneumonia continuous positive airway pressure; positive end-expiratory pressure; COVID-19; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); respiratory failure; helmet; hypoxia; pneumonia

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MDPI and ACS Style

Radovanovic, D.; Rizzi, M.; Pini, S.; Saad, M.; Chiumello, D.A.; Santus, P. Helmet CPAP to Treat Acute Hypoxemic Respiratory Failure in Patients with COVID-19: A Management Strategy Proposal. J. Clin. Med. 2020, 9, 1191. https://doi.org/10.3390/jcm9041191

AMA Style

Radovanovic D, Rizzi M, Pini S, Saad M, Chiumello DA, Santus P. Helmet CPAP to Treat Acute Hypoxemic Respiratory Failure in Patients with COVID-19: A Management Strategy Proposal. Journal of Clinical Medicine. 2020; 9(4):1191. https://doi.org/10.3390/jcm9041191

Chicago/Turabian Style

Radovanovic, Dejan, Maurizio Rizzi, Stefano Pini, Marina Saad, Davide Alberto Chiumello, and Pierachille Santus. 2020. "Helmet CPAP to Treat Acute Hypoxemic Respiratory Failure in Patients with COVID-19: A Management Strategy Proposal" Journal of Clinical Medicine 9, no. 4: 1191. https://doi.org/10.3390/jcm9041191

APA Style

Radovanovic, D., Rizzi, M., Pini, S., Saad, M., Chiumello, D. A., & Santus, P. (2020). Helmet CPAP to Treat Acute Hypoxemic Respiratory Failure in Patients with COVID-19: A Management Strategy Proposal. Journal of Clinical Medicine, 9(4), 1191. https://doi.org/10.3390/jcm9041191

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