The CircumVent Project: a CPAP/O2 helmet solution for non-invasive ventilation using an implementation research framework.

• Authors: Aimalohi A. Ahonkhai, Vanderbilt University; Adesola Z. Musa, Nigerian Institute of Medical Research; Andre A. Fenton, New York University; Muktar H. Aliyu, Vanderbilt University; Ighovwerha Ofotokun, Emory University; Alex Hornstein, Ventilator Project, LLC; Baba M. Musa, Aminu Kano Teaching Hospital; Nnamdi Nwosu, University of Nigeria; Ifeoma Ulasi, University of Nigeria; Samuel Ajayi, University College Hospital; Catherine Falade, University College Hospital; Adedamola Dada, Federal Medical Centre; Aliyu Abdu, Aminu Kano Teaching Hospital; Mogaji Sunday, Federal Medical Centre; Adenike Odewabi, Lagos University Teaching Hospital; Muyiwa Rotimi, Federal Medical Centre; Onome Ogueh, Delta State University Teaching Hospital; Alan Steinbach, Jefferson Torresdale Hospital; Gbenga Ogedegbe, New York University; Babatunde L. Salako, Nigerian Institute of Medical Research; Oliver C. Ezechi, Nigerian Institute of Medical Research
• Journal Title: Implement Sci Commun
• Volume: Volume 2, Number 1
• Publisher: BMC | 2021-08-26, Pages 93-93
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1186/s43058-021-00193-y
• Subjects: Biology, Virology; Health Sciences, Immunology
• Keywords: Implementation science; Nigeria; Non-invasive ventilation; SARS-CoV-2, COVID-19 infection

Abstract

BACKGROUND: Acute respiratory failure, a major cause of death in COVID-19, is managed with high-flow oxygen therapy via invasive mechanical ventilation. In resource-limited settings like Nigeria, the shortage of ventilators and oxygen supply makes this option challenging. Evidence-based non-invasive alternatives to mechanical ventilation such as the use of continuous positive airway pressure (CPAP) devices exist, but there have been concerns that non-invasive ventilation may expose healthcare workers to infection from aerosolized dispersion of SARS-CoV-2. We propose to evaluate the feasibility, adaptability and acceptability of a CPAP/O2 helmet solution for non-invasive ventilation among patients with COVID-19 and health workers in eight COVID-19 treatment and isolation centers in Nigeria. METHODS: The study will occur in 4 stages: (1) convene a Steering Committee of key stakeholders and recruit implementation sites; (2) use the integrated Promoting Action on Research Implementation in Health Services (i-PARiHS) framework to guide a needs assessment of treatment centers' capacity to use high-flow oxygen therapy to treat COVID-19 patients and utilize the findings to develop an implementation strategy for the use of a CPAP/O2 helmet solution; (3) build infrastructure to support training and data monitoring processes and to develop implementation protocols to evaluate the adaptability of the strategy for the use of the CPAP/O2 helmet; and (4) train health workers, distribute a CPAP/O2 helmet solution for non-invasive ventilation, pilot test the implementation strategy, and assess feasibility of its use and acceptability that includes monitoring altered risk of SARS-CoV-2 infection among healthcare workers. DISCUSSION: The CPAP/O2 helmet solution for non-invasive ventilation in Nigeria can serve as a scalable model for resource-poor countries, and beyond the COVID-19 pandemic, has the potential to be deployed for the treatment of pneumonia and other respiratory diseases. TRIAL REGISTRATION: NCT04929691. Registered June 18, 2021-retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04929691.