Intermittent High-Frequency Percussive Ventilation Therapy in 3 Patients with Severe COVID-19 Pneumonia

• Published in: The American journal of case reports Vol. 22; p. e928421
• Main Authors: Marchenko, Sergey P, Scarlatescu, Ecaterina, Vogt, Paul Robert, Naumov, Alexey, Bognenko, Sergey
• Format: Journal Article
• Language: English
• Published: United States International Scientific Literature, Inc 05.02.2021
• Subjects: Aged; Clinical Deterioration; Cough - therapy; Cough - virology; COVID-19 - complications; COVID-19 - therapy; Dyspnea - therapy; Dyspnea - virology; Female; High-Frequency Ventilation; Hospitalization; Humans; Lung - diagnostic imaging; Lung - virology; Male; Middle Aged; Oxygen Inhalation Therapy; Respiratory Insufficiency - prevention & control; Tomography, X-Ray Computed
• ISSN: 1941-5923; 1941-5923
• DOI: 10.12659/AJCR.928421

BACKGROUND High-frequency percussive ventilation (HFPV) is a method that combines mechanical ventilation with high-frequency oscillatory ventilation. This report describes 3 cases of patients with severe COVID-19 pneumonia who received intermittent adjunctive treatment with HFPV at a single center without requiring admission to the Intensive Care Unit (ICU). CASE REPORT Case 1 was a 60-year-old woman admitted to the hospital 14 days after the onset of SARS-CoV-2 infection symptoms, and cases 2 and 3 were men aged 65 and 72 years who were admitted to the hospital 10 days after the onset of SARS-CoV-2 infection symptoms. All 3 patients presented with clinical deterioration accompanied by worsening lung lesions on computed tomography (CT) scans after 21 days from the onset of symptoms. SARS-CoV-2 infection was confirmed in all patients by real-time reverse transcription-polymerase chain reaction (RT-PCR) assay from nasal swabs. All 3 patients had impending respiratory failure when non-invasive intermittent HFPV therapy was initiated. After therapy, the patients had significant clinical improvement and visibly decreased lung lesions on followup CT scans performed 4-6 days later. CONCLUSIONS The 3 cases described in this report showed that the use of intermittent adjunctive treatment with HFPV in patients with severe pneumonia due to infection with SARS-CoV-2 improved lung function and may have prevented clinical deterioration. However, recommendations on the use of intermittent HFPV as an adjunctive treatment in COVID-19 pneumonia requires large-scale controlled clinical studies. In the pandemic context, with a shortage of ICU beds, avoiding ICU admission by using adjunctive therapies on the ward is a useful option.