Generic placeholder image

Reviews on Recent Clinical Trials

Editor-in-Chief

ISSN (Print): 1574-8871
ISSN (Online): 1876-1038

Research Article

Efficacy of BAINS Circuit in Treating Critically Ill Hypoxemic COVID-19 Patients During the Second Wave of the Pandemic in India

Author(s): Vidya A. Patil, Saikrishna Prasad R., Shivanand L.K., Renuka Holyachi, Kusal K. Das* and Vijaykumar T.K.

Volume 17, Issue 2, 2022

Published on: 18 August, 2022

Page: [86 - 91] Pages: 6

DOI: 10.2174/1574887117666220308093306

Abstract

Background: The COVID-19 pandemic has encouraged doctors to look for novel ways of treating patients with respiratory failure due to the limited availability of ventilators and highflow nasal cannula. The study aims to assess the efficacy of using the Bains circuit as an alternative to HFNC and NIV as life-saving tools in patients with respiratory failure during the second wave of the COVID-19 pandemic in India.

Methods: This is a prospective interventional study carried out in the intensive care unit of Shri B.M Patil Medical College Hospital and Research Centre, Vijayapur, India, from May 2021 to June 2021. All patients (n=90) with respiratory failure not responding to therapy with an oxygen mask were included. Patients were placed on Bain circuits, one end connected to a non-invasive ventilation mask fitted to the face of the patients, and the other end connected to a central oxygen port. Patients’ vital parameters were assessed on an hourly basis. The blood gas analyses were done before and after using Bains.

Results: The study showed diabetes (33.4%), hypertension (22.2%), and diabetes with hypertension (11.1%) as comorbid factors among the ICU admitted patients. The results from the arterial blood gas analyses showed a statistically significant increase in Sp02 (%) and a decrease in respiratory rate (cycles/min) in the patients after being kept on Bains (p<0.05). Further, it showed that 72% of ICU patients with 70-79% Sp02 had a recovery by using Bains. The overall outcome of ICU admitted COVID-19 patients on Bains showed that 38.9% of patients improved and were shifted to 02/NRBM masks.

Conclusion: The study highlights a novel concept of using the Bains circuit as an effective alternative to HFNC and NIV for oxygenation in critically ill COVID-19 patients during scarcity of NIV and HFNC at the peak of the pandemic.

Keywords: COVID-19, comorbidities, respiratory failure, Bains circuit, lung, inflammation

Graphical Abstract

[1]
Mehta, Y.; Chaudhry, D.; Abraham, O.C. Critical care for COVID-19 affected patients: Position statement of the Indian society of critical care medicine. Indian J. Crit. Care Med., 2020, 24(4), 222-241.
[http://dx.doi.org/10.5005/jp-journals-10071-23395] [PMID: 32565632]
[2]
Tomashefski, J.F., Jr; Davies, P.; Boggis, C.; Greene, R.; Zapol, W.M.; Reid, L.M. The pulmonary vascular lesions of the adult respiratory distress syndrome. Am. J. Pathol., 1983, 112(1), 112-126.
[PMID: 6859225]
[3]
Anitha, G.F.; Velmurugan, L.; Sangareddi, S.; Nedunchelian, K.; Selvaraj, V. Effectiveness of flow inflating device in providing Continuous Positive Airway Pressure for critically ill children in limited-resource settings: A prospective observational study. Indian J. Crit. Care Med., 2016, 20(8), 441-447.
[http://dx.doi.org/10.4103/0972-5229.188171] [PMID: 27630454]
[4]
Bello, G.; De Santis, P.; Antonelli, M. Non-invasive ventilation in cardiogenic pulmonary edema. Ann. Transl. Med., 2018, 6(18), 355.
[http://dx.doi.org/10.21037/atm.2018.04.39] [PMID: 30370282]
[5]
WHO. COVID-19 clinical management living management 2021.
[6]
Parasher, A. COVID-19: Current understanding of its Pathophysiology, Clinical presentation and Treatment. Postgrad. Med. J., 2021, 97(1147), 312-320.
[http://dx.doi.org/10.1136/postgradmedj-2020-138577] [PMID: 32978337]
[7]
Huang, C.; Wang, Y.; Li, X. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 2020, 395(10223), 497-506.
[http://dx.doi.org/10.1016/S0140-6736(20)30183-5] [PMID: 31986264]
[8]
Roy, A.; Singh, A.; Khanna, P. Oxygen delivery devices in Covid-19 patients: Review and recommendation. Bali Journal of Anesthesiology, 2020, 4(5), 3.
[http://dx.doi.org/10.4103/BJOA.BJOA_62_20]
[9]
Peric, S.; Stulnig, T.M. Diabetes and COVID-19: Disease-management-people. Wien. Klin. Wochenschr., 2020, 132(13-14), 356-361.
[http://dx.doi.org/10.1007/s00508-020-01672-3] [PMID: 32435867]
[10]
Bikkina, S.; Kittu Manda, V.; Adinarayana Rao, U.V. Medical oxygen supply during COVID-19: A study with specific reference to State of Andhra Pradesh, India. Mater. Today Proc., 2021.
[http://dx.doi.org/10.1016/j.matpr.2021.01.196] [PMID: 33520673]

© 2024 Bentham Science Publishers | Privacy Policy