Nursing evaluation during treatment with helmet continuous positive airway pressure in patients with respiratory failure due to COVID-19 pneumonia: A case series.
Daniele Privitera, Nicolò Capsoni, Annamaria Mazzone and 6 others
PMID 34802843WHAT IT FOUND
In 52 emergency department patients with COVID-19 respiratory failure given helmet CPAP, 18 were intubated and 16 died.
No control group means these outcomes cannot show CPAP worked. Nursing checks every 30 minutes for 120 minutes were described.
Key findings
01Helmet CPAP monitoring recorded oxygen saturation, respiratory rate, pressure, oxygen fraction and temperature before the trial and every 30 minutes until 120 minutes.
02Eighteen patients were intubated, 34.62%, and sixteen patients died, 30.8%.
03Non-intubated patients used a lower mean pressure and had a faster decline in respiratory rate after the CPAP trial started.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was retrospective, single-centre and had no control group, so outcomes cannot be attributed to helmet CPAP or to nursing monitoring. The sample was small and no sample size calculation was done. Intubation and Do-Not-Intubate decisions were based on clinical judgment, not a randomised or fixed rule. Some patients also received oxygen support and hospital medications including hydroxychloroquine, steroids, Kaletra, azithromycin, tocilizumab or morphine, so the contribution of any single component cannot be separated.
Declared interests
The research received no specific grant, and the authors declared no conflict of interest.
The easy way to misread this
Do not read the 34.62% intubation rate or the 30.8% mortality as proof that helmet CPAP worked or failed. There was no control group, and some patients also received oxygen support and hospital medications including hydroxychloroquine, steroids, Kaletra, azithromycin, tocilizumab or morphine.