University College London Hospitals NHS Foundation Trust, London, UK
University College London Hospitals NHS Foundation Trust, London, UK.
Clin Med (Lond). 2021 Jul;21(4):e392-e394. doi: 10.7861/clinmed.2020-1086. Epub 2021 May 6.
No published protocol to guide the withdrawal of continuous positive airway pressure (CPAP) for patients with COVID-19 exists.
Description of the introduction of a novel protocol, developed by consensus to guide the withdrawal of CPAP for patients diagnosed as dying with COVID-19 in an acute hospital.
19 patients died on the high-dependency respiratory unit following treatment with CPAP. 89% died with CPAP withdrawn. The dying trajectory was difficult to predict. Symptoms were managed promptly and effectively with a combination of opioids, benzodiazepines and close medical supervision. No concerns were raised by families regarding the decision making or withdrawal process.
The use of the protocol ensures a comfortable and dignified death and supports the delivery of individualised care at the end of life. Future research on this topic should focus on qualitative outcomes and consider the applicability of this protocol in other patient groups.
目前尚无针对 COVID-19 患者的持续气道正压通气（CPAP）撤离的既定方案。
介绍一种新方案，通过共识制定，以指导急性医院中被诊断为 COVID-19 死亡患者的 CPAP 撤离。
19 名患者在接受 CPAP 治疗后在高依赖呼吸病房死亡。89%的患者在 CPAP 撤离后死亡。死亡轨迹难以预测。通过联合使用阿片类药物、苯二氮䓬类药物和密切的医疗监护，迅速有效地控制了症状。家属对决策或撤离过程没有提出任何担忧。
该方案的使用确保了舒适和有尊严的死亡，并支持在生命末期提供个体化护理。关于这一主题的未来研究应侧重于定性结果，并考虑该方案在其他患者群体中的适用性。
