Efficacy & safety of awake prone positioning on high flow nasal oxygen HFNO/BIPAP in management of moderate COVID-19 ARDS in covid designated tertiary care hospital

Abstract

Background: High flow nasal cannula oxygen (HFNO) is getting started to be used to deliver humidified oxygen in respiratory failure patients. In present study we assess HFNO compared to BIPAP in management of patients with ARDS following COVID-19.Study type: Retrospective Randomised Comparative observational study.Study place: LG hospital, AMCMET Medical College, Ahmedabad, Gujarat.Study period: April 2021 to June 2021.Methods: A retrospective analysis of 210 patients with COVID-19 and acute hypoxemic respiratory failure admitted to the intensive care unit (ICU), and treated by authors, 105 patients received HFNO as initial therapy, and 105 patients were primarily treated with BIPAP. There was no significant difference between the 2 groups in terms of baseline characteristics, laboratory tests, arterial blood gases, Haemodynamic parameters, PaO2/FiO2 values. Re-assessment after HFNO or BIPAP showed significant improvement (P< 0.05) in oxygenation parameters than baseline values. Results: The magnitude of improvement of oxygenation was not significantly different between patients using HFNO or BIPAP.Conclusion: Both HFNO/ BIPAP when used with awake proning can prevent endotracheal intubation in almost 90% of COVID-19 ARDS.