Post Covid Respiratory failure/Oxygen use
We are seeing patients who are post-Covid pneumonia with acute respiratory failure who are admitted for other problems but are still on oxygen from the previous admission. When would it be appropriate to query for chronic respiratory failure? How long would you consider them in a recovery phase of the Covid pneumonia?
My current case is a patient admitted 1/25 and discharged 2/8 with COVID pneumonia requiring Bipap with FiO2 of 100% and HFHH NC 100% 40/L. He responded well to treatment and discharged on 2/L NC.
Readmitted 10 days later with GI bleeding with ABLA, room air sats 72-86% requiring 2-4 L NC. Discharged on 2/L NC.
Readmitted 3/15 with GIB with ABLA, sats 84% on 6/L with room air sat of 79%. Weaned quickly to 2/L.
Diagnoses:
Recurrent GIB
Chronic hypoxia in setting of recent COVID-19 pneumonia
–Patient is still requiring oxygen from 2 to 4 L, concern for developing fibrosis associated with COVID-19
Considering just the respiratory status:
Would you consider him to be in the recovery phase of the acute respiratory failure?
Would you query for:
Acute on chronic respiratory failure
Chronic respiratory failure
No query?
Is there a guideline for how long a patient needs to be on home O2 before it is considered chronic?
How long would you consider the patient to be in a recovery phase of the acute illness?
Thanks for your thoughts!
Cynthia Mead RN CCDS