CPAP used at earlier stage helps save lives of hospitalised Covid patients

Continuous positive airway pressure (CPAP) used at an earlier stage for hospitalised patients with Covid-19 can help save lives, according to new research.

The results published in BMJ Respiratory Open show how CPAP treatment can be delivered effectively in a ward setting, with low resources both across the country and worldwide where intensive care bed availability is limited.

In the case of patients with severe acute respiratory syndrome, Covid-19 may cause the lungs to swell and collapse. Using CPAP treatment, which is often used at home to help people with sleep problems, helps to keep the lungs open and makes breathing easier.

The team led by Dr Abdul Ashish used the CPAP machines on patients with Covid-19 admitted to the Royal Albert Edward Infirmary in Wigan. Dr Luigi Sedda of Lancaster University analysed the results from the team at Wrightington, Wigan and Leigh Teaching Hospitals NHS Trust (WWL).

Dr Sedda said: “We show that Continuous Positive Airway Pressure (CPAP) in the first days of hospitalisation seems to save between 10% to 20% of patients. However it is important to underline that this was a pilot study with a small sample size, although comforting evidence is starting to emerge elsewhere.”

CPAP allows the patient to recover from the inflammatory effects of Covid

According to NHS England, 96% of people who died with Covid had at least one serious health condition and the majority are over the age of 80. The research has so far helped almost a hundred patients at the Royal Albert Edward Infirmary.

Consultant Respiratory Physician Dr Ashish added: “When you use CPAP early in the admission it stops the patient getting worse, therefore avoiding invasive ventilation techniques. As CPAP is readily available and can be used in a ward setting, we have demonstrated that, when used early, it can be very effective way of treating severe COVID-19 pneumonia.

“We are one of the early adopters of ward based CPAP in the North West and have developed local protocols and pathways by modifying our existing CPAP machines to deliver good outcomes for our patients.”

The researchers also found that the early use of CPAP potentially reduces lung damage during the worst of the Covid-19 infection and allows the patient to recover from the inflammatory effects. However, when used later, CPCP does not prevent lung damage thus leading to additional inflammation and a reduction in survival chances.