Study of oxygen delivery methods use in the COVID-19 patients

Abstract

Background: The oxygen crisis globally during the Corona virus disease-19 (COVID-19) pandemic reflected the need of appropriate and economic use of oxygen in its management. There is scarce report of the use of different oxygen delivery methods (ODMs) in COVID-19 patients in our region.  

Methods: This was a hospital-based observational study conducted from July 2021 to October 2021. We studied various ODMs used by 100 COVID-19 patients, aged 18 years or above admitted to Chitwan Medical College and Teaching Hospital during July to October 2021 and the trend of how the ODMs changed during the hospital stay. Data analysis was done by SPSS version 20 for Windows. Fisher’s exact and Kruskal Wallis tests were used to analyze the data of the participants.

Results: In our study, oxygen supplementation at presentation using nasal cannula was required by 74% of patients, face mask by 13%, Venturi mask 34%, non-rebreathing mask 25%, high-flow nasal cannula 27%, non-invasive ventilation 6%, and invasive mechanical ventilation by 21%. There was significant difference in the use of ODMs at presentation among the moderate, severe and critical COVID-19 groups (P<0.001). There was a wide range of switching between various ODMs during the treatment course.

Conclusions: Nasal cannula was the most common ODM followed by venturi devices and invasive mechanical ventilation. Despite varying oxygen flow requirements, aerosol risks, merits and limitations of different ODMs, they can be appropriately used in various COVID-19 management situations. Besides inspired oxygen concentration and oxygen flow, patients’ condition, tolerance and availability of the resource also affected the choices of ODMs to achieve the correction of hypoxemia.