Comparison of the different oxygen delivery and ventilatory support methods for treating patients with COVID-19 induced type 1 hypoxemic respiratory failure

Abstract

Having claimed the lives of over five million people in the span of two years, SARS-COV-2 caused a global health crisis and a debate between clinicians on the best respiratory interventions to use in fighting this disease. This paper aims to evaluate the different methods of respiratory support at a clinician’s disposal when treating COVID-19 induced type 1 hypoxemic respiratory failure. Data was acquired by running a literature search on MEDLINE and Web of Science using terms such as “COVID-19”, “Mortality”, “CPAP”, “Outcomes”. From 355 papers found, 11 are included in this paper. Studies have shown both CPAP and HFNO are effective when treating mild hypoxemia in COVID-19 patients, however if they fail, then chances of patient survival are slim, even if a patient’s treatment is escalated. The literature has shown that mechanical ventilation has a slightly higher survival rate than both CPAP and HFNO when used as a primary treatment and patients who are escalated to mechanical ventilation have a slim chance of survival. Considering the findings, it is crucial that clinicians consider factors such as a patient’s initial PaO2/FiO2 as well as age when deciding on whether a patient should be ventilated or treated with CPAP or HFNO.