RT Journal Article
SR Electronic
T1 Implementing a novel protocol for withdrawal of CPAP support in COVID-19 patients: a case series
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP e392
OP e394
DO 10.7861/clinmed.2020-1086
VO 21
IS 4
A1 Natalie Webber
A1 Malcolm Avari
A1 Georgina Harridge
A1 Jane Neerkin
A1 Emily Collis
A1 Ronan Astin
YR 2021
UL http://www.rcpjournals.org/content/21/4/e392.abstract
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19 patients died on the high-dependency respiratory unit following treatment with CPAP. 89% died with CPAP withdrawn.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.