A 55 ‐year‐old COVID‐19‐positive man managed with self‐regulation of high‐flow oxygen by high‐velocity nasal insufflation therapy

We present a case report on a 55 ‐year‐old male with obstructive sleep apnoea (OSA), diabetes, and obesity requiring escalation to high‐flow oxygen by high‐velocity nasal insufflation (HVNI; Vapotherm). As this patient required frequent clinician interaction and use of personal protective equipment (PPE) to control flow rat e and oxygen fraction due to lability, and the patient was alert, we instructed the patient to modify the oxygen to maintain an SpO2 (peripheral capillary oxygen saturation) target range and flow rate, to address dyspnoea as well as reduction of flow, as tolerated, when other staff entered the room. This was a successful 10 ‐day self‐regulation of HVNI, wherein on day 14 the patient was discharged. AbstractManagement of critically ill coronavirus disease 2019 (COVID ‐19) patients remains both risky and technically challenging. A 55‐year‐old male COVID‐19‐positive patient with obstructive sleep apnoea (OSA), diabetes, and obesity presented with cough and shortness of breath, escalating to requiring high‐flow oxygen therapy by high‐velocity nasal in sufflation. The patient's flow rate and oxygen fraction remained labile throughout much of the hospitalization. This lability required frequent clinician interactions and use of personal protective equipment. The patient was alert and oriented and was instructed on the operation of the high‐flow s ystem, specifically the adjustment of both flow rate and oxygen percentage. The patient w...
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research