LAUSR

During COVID-19 pandemic, intensive care and non-invasive ventilation (NIV) units have collapsed, forcing physicians to improvise alternative methods of respiratory support One of these systems that had to be used in our hospital consists of an antistatic reservoir bag that receives oxygen at a flow of 15 litters per minute connected by a 'T' tube to an oronasal mask and to a PEEP valve We developed a retrospective and descriptive study to improve knowledge of the effect of this dispositive All patients (n=48) had severe respiratory failure due to bilateral pneumonia caused by SARS-cov-2 infection (confirmed by RT-PCR) The mean age was 66 3±12 9 years Male was the most frequent sex (66 7%) Principal comorbidities were arterial hypertension (58 3%), mellitus diabetes (35 4%) and sleep apnea-hypopnea syndrome (20 8%) 26 patients (54 2%) had do-not-intubate (DNI) directives and they couldn't access to NIV either Time from clinical onset to the dispositive use was 10 1±4 4 days The 'home-made' CPAP was used during 3 4±2 8 days During this time, most used pharmacological treatments were tocilizumab (60 4%) and systemic corticosteroids (56 3%) Main reasons for interrupting 'home-made' CPAP system were: dead (33 3%);good clinical course and change to conventional oxigenotherapy (27 1%);change to invasive mechanical ventilation (16 7%);change to NIV (14 6%) Overall mortality was 56 3%;73 5% at DNI group and 28 1% at the other group Despite the use of this home-made CPAP, mortality rate remains high in the DNI group which suggests that the device may not be a proper respiratory support However, in some cases it could be used as a respiratory support while other treatments become effective