Respiratory Strategies in COVID-19

The Resus Room

Simon Laing

Science, Emergencymedicine, Medicine, Health & Fitness, Em, Ae

4.8 • 678 Ratings

🗓️ 10 April 2020

⏱️ 18 minutes

🔗️ Recording | iTunes | RSS

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Summary

So COVID-19 has produced a multitude of challenges to healthcare providers, the response to these challenges has been phenomenal.

One uncertainty is the strategy we should employ for hypoxic respiratory failure and several high quality guidelines have presented conflicting advice for the severely hypoxic patient.

The Warwick Clinical Trials Unit has already begun recruiting patients to their RECOVERY-RS trial, which is open for hospitals in the UK to sign up for. This looks at 3 different strategies of respiratory support for patients admitted with suspected or known COVID-19 and hypoxia; namely CPAP, High-flow nasal oxygen and standard care. The trial is funded by the NIHR and supported by the Intensive Care Society.

In this episode we get a chance to speak to Bronwen Connolly, one of the investigators of the RECOVERY-RS trial; we discuss the background evidence, the trial design, and when results will be available.

As always we’d love to hear any thoughts or comments you have on the website and via twitter, and make sure you take a look at the protocol yourself.

Enjoy!

Simon, Rob & James

Transcript

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0:00.0	Welcome to the Recess Room podcast.
0:03.5	Five, four, three, two, one, fire.
0:12.0	So hi, and welcome back to the Recess Room podcast. I'm Simon Lang.
0:16.5	And I'm Rob Fenwick. And I'm James Yates.
0:18.3	And this is an extra special podcast episode because there's a huge trial that has just started recruiting, Recovery RS, which looks to answer a huge clinical dilemma in our patients that are really sick with COVID-19. Indeed, it is time to break radio silence regarding COVID-19 from the recess room podcast.
0:39.7	We need to get it on there.
0:41.7	Before we get into the podcast, a huge thanks to S.J. Trem, the Scandinavian Journal of Trauma,
0:46.6	resuscitation and emergency medicine who collaborate with us on this podcast.
0:50.6	Make sure you go and check out their superb resource available on Hyperlick from the
0:55.5	recess room site. But without further ado, let's crack into the podcast. Okay, so I think
1:03.6	it's fair to say that in the last few weeks around the UK and globally, we've seen some
1:09.4	really, really sick patients with COVID-19.
1:13.4	And those that are suffering from a hypoxic respiratory failure, there's a huge dilemma,
1:19.2	not only when they should be intubated, but actually what we do with them before they require
1:25.3	intubation. So not the bridge to it, but how we should really deal with
1:29.2	their hypoxia in this intermediate but very sick stage. Now, Rob, you're working up in Birmingham,
1:36.1	and I know you've got a huge number of patients coming through your department. So what are the
1:40.5	sort of strategies that you've seen? Well, I mean, I think we've been in a fairly hot spot where I work anyway,
1:46.5	and it's hit home very quickly just how big a problem this potentially is.
1:51.2	And I think, you know, just taking a step back through it, I mean, fundamentally this is a disease
1:55.3	that we don't know a huge amount about.
1:58.4	And there's a lot of uncertainty regarding essentially every element of
	...

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