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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