Queens study finds oxygen treatment method has potential to reduce ICU admissions

Queens study finds oxygen treatment method has potential to reduce ICU admissions

Medical staff in the respiratory emergency department at Craigavon Area Hospital in Co Armagh, Northern Ireland. Picture: PA

Patients hospitalised with Covid-19 could avoid invasive ventilation and free up space in intensive care with one method of oxygen delivery, a Queens University Belfast study has found. 

The landmark research conducted with the University of Warwick compared three common respiratory intervention techniques to find which method works best for Covid-19 patients. 

It found that oxygen and positive pressure delivered via a tightly fitting mask (CPAP) attached to patients resulted in fewer people requiring invasive mechanical ventilation from Covid-19-a potential relief for intensive care services. 

Oxygen conserved 

More oxygen might be made available in hospitals as a result of the study as well, as researchers found no benefit from high flow nasal oxygenation (HFNO) over standard oxygen therapy for Covid patient outcomes. 

A nurse wearing PPE works on a patient in the ICU (Intensive Care Unit) in St George's Hospital in London. Picture: PA 
A nurse wearing PPE works on a patient in the ICU (Intensive Care Unit) in St George's Hospital in London. Picture: PA 

HFNO requires large amounts of oxygen and is delivered up the nose of a patient. 

The three methods examined: CPAP, HFNO, and standard oxygen therapy are commonly used to treat Covid-19 patients before they are moved onto invasive ventilation in a critical care bed. 

Until now it was not known which resulted in better outcomes for patients. 

Research benefits

Speaking about the research, Professor Danny McAuley, Chief Investigator and Professor and Consultant in Intensive Care Medicine at the Royal Victoria Hospital and Queen's University Belfast said the pandemic has placed a huge strain on hospital resources. 

"Over the Covid pandemic, we've seen a large number of patients requiring high levels of oxygen and admission to ICU for invasive ventilation, causing a huge strain on staff and beds," he said. 

"The results of this trial are really encouraging as they have shown that by using CPAP, invasive ventilation may not be needed for many patients with Covid-19 requiring high oxygen levels." 

Covid waves of infection across the world have resulted in rising intensive care admissions throughout the pandemic. Picture: PA 
Covid waves of infection across the world have resulted in rising intensive care admissions throughout the pandemic. Picture: PA 

Prof McAuley said there was potential for the research to be applied everywhere and improve patient outcomes while increasing hospital resources. 

Avoiding invasive ventilation is not only better for the patients, but it also has important resource implications as it frees up ICU capacity. 

"This research should help healthcare professionals in the UK and beyond manage patients with Covid-19, to improve patient outcomes while helping to lessen the burden on resources," he said. 

The study

RECOVERY-RS, led by Queen’s University Belfast and the University of Warwick, is the world’s largest non-invasive respiratory support study for Covid-19 - with over 1200 participants taking part across 48 UK hospitals.

Between April 2020 and May 2021, a total of 1,272 hospitalised Covid-19 patients with acute respiratory failure were recruited to the study and randomly allocated to receive one of three oxygen treatment methods. 

Patients were assessed for two outcomes: the number of patients admitted for invasive ventilation or died within 30 days of beginning the trial. 

Both CPAP and HFNO have been widely used worldwide in the management of Covid-19 throughout the pandemic for patients who need extra oxygen. 

If these treatments are not successful, patients need to be sedated and treated with a ventilator in intensive care. 

Although both CPAP and HFNO are commonly used in other lung conditions, prior to the RECOVERY-RS study, it was unknown how safe and effective they were for people with breathing difficulties arising from Covid-19.


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