PT - JOURNAL ARTICLE AU - Natalie Webber AU - Malcolm Avari AU - Georgina Harridge AU - Jane Neerkin AU - Emily Collis AU - Ronan Astin TI - Implementing a novel protocol for withdrawal of CPAP support in COVID-19 patients: a case series AID - 10.7861/clinmed.2020-1086 DP - 2021 May 06 TA - Clinical Medicine PG - clinmed.2020-1086 4099 - http://www.rcpjournals.org/content/early/2021/05/06/clinmed.2020-1086.short 4100 - http://www.rcpjournals.org/content/early/2021/05/06/clinmed.2020-1086.full AB - Background No published protocol to guide the withdrawal of continuous positive airway pressure (CPAP) for patients with COVID-19 exists.Case series Description of the introduction of a novel protocol, developed by consensus to guide the withdrawal of CPAP for patients diagnosed as dying with COVID-19 in an acute hospital.Outcome 19 patients died on the high-dependency respiratory unit following treatment with CPAP. 89% died with CPAP withdrawn. The dying trajectory was difficult to predict. Symptoms were managed promptly and effectively with a combination of opioids, benzodiazepines and close medical supervision. No concerns were raised by families regarding the decision making or withdrawal process.Discussion The use of the protocol ensures a comfortable and dignified death and supports the delivery of individualised care at the end of life. Future research on this topic should focus on qualitative outcomes and consider the applicability of this protocol in other patient groups.