Helmet CPAP treatment in patients with COVID-19 pneumonia: a multicentre cohort study

Patients with coronavirus disease 2019 (COVID-19) pneumonia can develop hypoxaemic acute respiratory failure (hARF) with the need for positive end-expiratory pressure (PEEP). The administration of continuous positive airway pressure (CPAP) through a helmet improves oxygenation and avoids intubation [1, 2]. A European consensus document suggests that helmet CPAP should be the first therapeutic choice for hARF caused by COVID-19 pneumonia, mainly for minimising aerosol generation [3–5]. However, recommendations are based on experts' opinion and consider only evidence obtained in critically ill COVID-19 patients [3]. The Surviving Sepsis Campaign does not recommend the administration of CPAP for the initial management of severe COVID-19 [6]. Helmet CPAP treatment fails in up to 44% of patients with moderate-to-severe hypoxaemic acute respiratory failure due to COVID-19 pneumonia https://bit.ly/3g7FAB8