Invasive vs. Non-Invasive CPAP Ventilations in RDS Covid-19 Patients

Abstract

Background: When the first wave of the Covid-19 pandemic attacked Iraq, more than 80% of I.C.U admitted patients received mechanical ventilation, although half of them started with non-invasive ventilation, but after 24-72 hours, they required invasive ones. This study was done to compare the invasive to non-invasive ventilations between RDS pneumonia (respiratory distress syndrome) Covid-19 patients respectfully to prone positioning procedure for patients with invasive ventilation and turning the patients into invasive ventilations for those who have not to get benefit from non-invasive ventilation or get deteriorated clinically, revealing the best outcome. Methods: Seventy patients between (20-50) years old, randomly gender selected for this study, consent granted from the patients and their families, and institutional board approval after I.C.U. Admission and diagnosed them as RDS pneumonia Covid-19, half of them were selected for early invasive ventilation, the other half started with non-invasive CPAP ventilation, and both groups were closely monitored. The treatments were mostly the same for all patients. Otherwise, there was no difference mentioned in the management except for the ventilator setting as it differs from patient to patient. Following up on the patients, close observation, recording the response, and delicate weaning from the mechanical ventilation all were the parameters on which the study depends on. Results: The first group (I) with early invasive ventilation showed less death rate and early discharge from I.C.U. with positive clinical results, in contrast to the second group (N) showed more death rate and more than three-quarters of them converted into invasive ventilation as their non-invasive CPAP ventilation didn’t meet their requirement. Conclusion: Although invasive ventilation requires sedation and has many complications, but it is still the only pathway for securing the airway, and it meets many modes of ventilations that might be comfort to the patient. The better outcome results for RDS pneumonia Covid-19 patients showed with early invasive ventilation