Discussion Forum


Case discussion - A patient with severe COVID-19 and acute hypoxemic respiratory failure

By: Marcelo Alcantara, Médico - 02/23/2022 19:31

A 50 years-old, unvaccinated patient, was admitted to the ICU with severe COVID-19 in Fortaleza, Brazil, in January 2022.

His SpO2 dropped to 92% with HFNC with FIO2 around 60%, no hypercapnia or acidemia.

Physicians were considering using HelmetCPAP with a new Brazilian device, the ELMO.

Tomaz BS, Gomes GC, Lino JA, Menezes DGA, Soares JB, Furtado V, et al. ELMO, a new helmet interface for CPAP to treat COVID-19-related acute hypoxemic respiratory failure outside the ICU: a feasibility study. J Bras Pneumol. 2022;48(1):e20210349

The chest X-ray at ICU admission:

What is your opinion?

He received corticosteroids and broad-spectrum antibiotics.

Questions for discussion:

1- Would you perform other image studies?

2- What kind of NIV support would be interesting to try before indicating intubation and invasive MV?

3- Have you had experience with the HELMET or other types of interface in COVID-19 patients?



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