Dual High Flow Oxygen Therapy and CPAP Ventilation in a Single Device for COVID-19
DOI:
https://doi.org/10.14738/jbemi.76.9324Keywords:
COVID-19, HFOT, CPAP, dual therapy, flow driver, humidifierAbstract
High flow oxygen therapy (HFOT) and Continuous positive airway pressure (CPAP) could be considered the most important ventilatory therapies during the COVID-19 pandemic because of their frequency of use. There are many devices on the market which provide this type of ventilatory support, and these should be distinguished from one another by their efficacy, versatility, patient comfort, hygiene and cost. We evaluated the AquaVENT FD140i from Armstrong Medical, which delivers both HFOT and CPAP, concluding that it provides two potentially efficacious treatments to COVID-19 patients, while its long-life battery facilitates transfers for escalation and de-escalation of care. We compared the AquaVENT FD140i with the Fisher & Paykel MR850, which is a gold standard in the market. We also looked at the compatibility of their humidifier and disposables with Armstrong Medical devices. The results of this study suggest the compatibility of both systems, which has the potential to reduce consumable costs.
References
(1) Sharma S, Danckers M, Sanghavi D, Chakraborty RK. High Flow Nasal Cannula. StatPearls. StatPearls Publishing; 2020
(2) Pinto VL, Sharma S. Continuous Positive Airway Pressure (CPAP). StatPearls. StatPearls Publishing; 2020
(3) Tobin MJ, Laghi F, Jubran A. Caution about early intubation and mechanical ventilation in COVID-19. Vol. 10, Annals of Intensive Care. Springer; 2020. p. 78
(4) Tobin MJ. Basing respiratory management of COVID-19 on physiological principles. Vol. 201, American Journal of Respiratory and Critical Care Medicine. American Thoracic Society; 2020. p. 1319–20.
(5) Yao W, Wang T, Jiang B, Gao F, Wang L, Zheng H, et al. Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations. Br J Anaesth. 2020 Jul 1;125[1]:e28–37.
(6) Gattinoni L, Coppola S, Cressoni M, Busana M, Rossi S, Chiumello D. COVID-19 does not lead to a “typical” acute respiratory distress syndrome. Vol. 201, American Journal of Respiratory and Critical Care Medicine. American Thoracic Society; 2020. p. 1299–300.
(7) Fowler AJ, Wan YI, Carenzo L, Haines RW. COVID-19 phenotypes and potential harm of conventional treatments: How to prove the hypothesis. Vol. 202, American Journal of Respiratory and Critical Care Medicine. American Thoracic Society; 2020. p. 619–21.
(8) Jain A, Doyle DJ. Stages or phenotypes? A critical look at COVID-19 pathophysiology. Vol. 46, Intensive Care Medicine. Springer; 2020. p. 1494–5.
(9) Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Vol. 46, Intensive Care Medicine. Springer; 2020. p. 1099–102.
(10) Tobin MJ, Laghi F, Jubran A. Ventilatory failure, ventilator support, and ventilator weaning. Vol. 2, Comprehensive Physiology. Compr Physiol; 2012. p. 2871–921.
(11) Higgs A, McGrath BA, Goddard C, Rangasami J, Suntharalingam G, Gale R, et al. Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth. 2018 Feb 1; 120[2]:323–52.
(12) Kalanuria AA, Zai W, Mirski M. Ventilator-associated pneumonia in the ICU. Vol. 18, Critical Care. BioMed Central Ltd.; 2014
(13) Li J, Fink JB, Ehrmann S. High-flow nasal cannula for COVID-19 patients: low risk of bio-aerosol dispersion. Vol. 55, The European respiratory journal. NLM; 2020
(14) Iwashyna TJ, Boehman A, Capelcelatro J, Cohn A, Cooke J, Costa DK, et al. Variation in Aerosol Production Across Oxygen Delivery Devices in Spontaneously Breathing Human Subjects. medRxiv. 2020 Apr 20
(15) Kotoda M, Hishiyama S, Mitsui K, Tanikawa T, Morikawa S, Takamino A, et al. Assessment of the potential for pathogen dispersal during high-flow nasal therapy. J Hosp Infect. 2020 Apr 1;104[4]:534–7.
(16) Rello J, Pérez M, Roca O, Poulakou G, Souto J, Laborda C, et al. High-flow nasal therapy in adults with severe acute respiratory infection. A cohort study in patients with 2009 influenza A/H1N1v. J Crit Care. 2012 Oct 1;27[5]:434–9.
(17) Rochwerg B, Granton D, Wang DX, Helviz Y, Einav S, Frat JP, et al. High flow nasal cannula compared with conventional oxygen therapy for acute hypoxemic respiratory failure: a systematic review and meta-
analysis. Vol. 45, Intensive Care Medicine. Springer Verlag; 2019. p. 563–72.
(18) Patel M, Gangemi A, Marron R, Chowdhury J, Yousef I, Zheng M, et al. Retrospective analysis of high flow nasal therapy in COVID-19-related moderate-to-severe hypoxaemic respiratory failure. Vol. 7, BMJ Open Respiratory Research. BMJ Publishing Group; 2020. p. e000650.
(19) Mas A, Masip J. Noninvasive ventilation in acute respiratory failure. Vol. 9, International Journal of COPD. Dove Medical Press Ltd.; 2014. p. 837–52.
(20) Ñamendys-Silva SA. Respiratory support for patients with COVID-19 infection. Vol. 8, The Lancet Respiratory Medicine. Lancet Publishing Group; 2020. p. e18.