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Open Access 01-12-2020 | COVID-19 | Research

Surgical mask on top of high-flow nasal cannula improves oxygenation in critically ill COVID-19 patients with hypoxemic respiratory failure

Authors: Virginie Montiel, Arnaud Robert, Annie Robert, Anas Nabaoui, Tourneux Marie, Natalia Morales Mestre, Maerckx Guillaume, Pierre-François Laterre, Xavier Wittebole

Published in: Annals of Intensive Care | Issue 1/2020

Abstract

Objective

Critically ill patients admitted in ICU because of COVID-19 infection display severe hypoxemic respiratory failure. The Surviving Sepsis Campaign recommends oxygenation through high-flow nasal cannula over non-invasive ventilation. The primary outcome of our study was to evaluate the effect of the addition of a surgical mask on a high-flow nasal cannula system on oxygenation parameters in hypoxemic COVID-19 patients admitted in ICU who do not require urgent intubation. The secondary outcomes were relevant changes in PaCO₂ associated with clinical modifications and patient’s feelings.

Design

We prospectively assessed 21 patients admitted in our mixed Intensive Care Unit of the Cliniques Universitaires Saint Luc.

Main results

While FiO2 was unchanged, we demonstrate a significant increase of PaO₂ (from 59 (± 6), to 79 mmHg (± 16), p < 0.001), PaO₂/FiO₂ from 83 (± 22), to 111 (± 38), p < 0.001) and SaO₂ (from 91% (± 1.5), to 94% (± 1.6), p < 0.001), while the patients were under the surgical mask. The SpO₂ returned to pre-treatment values when the surgical mask was removed confirming the effect of the device rather than a spontaneous positive evolution.

Conclusion

A surgical mask placed on patient’s face already treated by a High-flow nasal cannula device improves COVID-19 patient’s oxygenation admitted in Intensive Care Unit for severe hypoxemic respiratory failure without any clinically relevant side.

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Title: Surgical mask on top of high-flow nasal cannula improves oxygenation in critically ill COVID-19 patients with hypoxemic respiratory failure
Authors: Virginie Montiel
Arnaud Robert
Annie Robert
Anas Nabaoui
Tourneux Marie
Natalia Morales Mestre
Maerckx Guillaume
Pierre-François Laterre
Xavier Wittebole
Publication date: 01-12-2020
Publisher: Springer International Publishing
Keyword: COVID-19
Published in: Annals of Intensive Care / Issue 1/2020
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/s13613-020-00744-x

At a glance: The STEP trials

Springer Medicine

Surgical mask on top of high-flow nasal cannula improves oxygenation in critically ill COVID-19 patients with hypoxemic respiratory failure

Abstract

Objective

Design

Main results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Design

Main results

Conclusion

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