Littlejohns Anna, Please Helen, Musasizi Racheal, Murdoch Stuart, Nampiina Gorret, Waters Ian, Birch William Davis, de Boer Gregory, Kapur Nikil, Ambrozi Tumwesigye, Carol Ninsiima, Noel Nakigudde, Parmar Jiten, Culmer Peter, Lawton Tom, Namulema Edith
Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, West Yorkshire, UK.
Mengo Hospital, Sir Albert Cook Road, Mengo, P. O. Box 7161, Kampala, Uganda.
Trop Med Health. 2023 Aug 7;51(1):42. doi: 10.1186/s41182-023-00533-9.
Continuous positive airway pressure (CPAP) has been a key treatment modality for Coronavirus Disease 2019 (COVID-19) worldwide. Globally, the demand for CPAP outstripped the supply during the pandemic. The LeVe CPAP System was developed to provide respiratory support for treatment of COVID-19 and tailored for use in low- and middle-income country (LMIC) settings. Prior to formal trial approval, received in November 2021, these devices were used in extremis to support critically unwell adult patients requiring non-invasive ventilatory support.
This is a retrospective descriptive review of adult patients with COVID-19 pneumonitis, who were treated with advanced respiratory support (CPAP and/or high-flow nasal oxygen, HFNO) at Mengo Hospital, Uganda. Patients were treated with the LeVe CPAP System, Elisa CPAP and/or AIRVO™ HFNO. Treatment was escalated per standard local protocols for respiratory failure, and CPAP was the maximum respiratory support available. Data were collected on patient characteristics, length of time of treatment, clinical outcome, and any adverse events.
Overall 333 patients were identified as COVID-19 positive, 44 received CPAP ± HFNO of which 43 were included in the study. The median age was 58 years (range 28-91 years) and 58% were female. The median duration of advanced respiratory support was 7 days (range 1-18 days). Overall (all device) mortality was 49% and this was similar between those started on the LeVe CPAP System and those started non-LeVe CPAP System devices (50% vs 47%).
The LeVe CPAP system was the most used CPAP device during the pandemic, bringing the hospital's number of available HFNO/CPAP devices from two to 14. They were a critical resource for providing respiratory support to the sickest group of patients when no alternative devices were available. The devices appear to be safe and well-tolerated with no serious adverse events recorded. This study is unable to assess the efficacy of the LeVe CPAP System; therefore, formal comparative studies are required to inform further use.
持续气道正压通气（CPAP）一直是全球范围内治疗2019冠状病毒病（COVID-19）的关键治疗方式。在全球范围内，疫情期间对CPAP的需求超过了供应。LeVe CPAP系统的开发是为了为COVID-19的治疗提供呼吸支持，并针对低收入和中等收入国家（LMIC）的使用情况进行了定制。在2021年11月获得正式试验批准之前，这些设备被紧急用于支持需要无创通气支持的病情严重的成年患者。
这是一项对乌干达蒙戈医院接受高级呼吸支持（CPAP和/或高流量鼻氧，HFNO）治疗的COVID-19肺炎成年患者的回顾性描述性研究。患者接受LeVe CPAP系统、Elisa CPAP和/或AIRVO™ HFNO治疗。根据当地标准的呼吸衰竭治疗方案逐步升级治疗，CPAP是可用的最大呼吸支持。收集了患者特征、治疗时间、临床结局和任何不良事件的数据。
共确定333例患者COVID-19呈阳性，44例接受CPAP±HFNO治疗，其中43例纳入研究。中位年龄为58岁（范围28-91岁），58%为女性。高级呼吸支持的中位持续时间为7天（范围1-18天）。总体（所有设备）死亡率为49%，开始使用LeVe CPAP系统的患者和开始使用非LeVe CPAP系统设备的患者死亡率相似（50%对47%）。
LeVe CPAP系统是疫情期间使用最多的CPAP设备，使医院可用的HFNO/CPAP设备数量从两台增加到14台。当没有其他替代设备时，它们是为病情最严重的患者群体提供呼吸支持的关键资源。这些设备似乎安全且耐受性良好，未记录到严重不良事件。本研究无法评估LeVe CPAP系统的疗效；因此，需要进行正式的比较研究以指导进一步使用。
