Letter regarding the Use of Continuous Positive Airway Pressure (CPAP) for COVID-19 positive patients
Use of Continuous Positive Airway Pressure (CPAP) for COVID-19 positive patients
As more information regarding critical care treatment for COVID-19 is gathered from around the world, especially from our colleagues in Italy, it is important to constantly review all guidance that has been issued.
There is a growing evidence base that there is a significant role for the use of CPAP in COVID-19 positive patients, more so than was initially understood. First reports from China suggested that early intubation and ventilation was preferable to introducing delay by the use of CPAP. However, it is now clearer that CPAP may be of benefit to patients earlier on in the disease process than first thought and may prevent deterioration of some patients to the extent of them not going on to need invasive ventilation.
There will obviously be patients who will require immediate intubation and invasive ventilation at the time of presentation but, in light of this additional information the recent NICE guidelines have been updated to include the use of CPAP in the early stages of the disease. We will also be asking for the procurement of equipment to provide this. Please refer to the updated specialty guide for more detailed information.
Professor Jane Eddleston
Chair, NHS England Adult Critical Care Clinical Reference Group
Dr Alison Pittard
Dean, Faculty of Intensive Care Medicine
Letter produced by the Faculty and the NHSE Adult Critical Care Clinical Reference Group and endorsed by the Intensive Care Society