Effectiveness of non-invasive ventilation in acute respiratory failure by Covid-19 at Befelatanana hospital Antananarivo - 17/02/23

Doi : 10.1016/j.rmr.2022.11.051 
F.P.P. Andriamahenina 1, , M. Tiaray Harison 1, A.M. Nandimbiniaina 1, L. Rebasy 2, F.A. Martin 2, S.M. Razafimpihanina 1, A.Z. Razafindrasoa 1, D.O. Andriarimanga 1, O.F. Rakotondrasoa 1, K. Ravahatra 2, J.R. Rakotomizao 1, J.L. Rakotoson 1, R.N. Raharimanana 2
1 Department of Pneumology, Joseph Raseta Befelatanana University Hospital, Antananarivo, Madagascar 
2 Department of Pneumology, Fenoarivo University Hospital, Antananarivo, Madagascar 

Corresponding author.

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Non-invasive ventilation can be used for the management of acute respiratory distress syndrome in Covid-19 patients. The objective of our study is to describe the profile of severe covid-19 patients with non-invasive ventilation seen in the Joseph Raseta Befelatanana University Hospital in Antananarivo, Madagascar.


This was a descriptive prospective observational study from April 1 to June 30, 2021, including all confirmed cases of Covid-19 by RT-PCR, severe form whose Sa02/Fi02 ratio is315 whose non-invasive ventilation was the ventilation support used. Non-invasive ventilation parameters: Fi02 for Sp0292%; EPAP 4–8cmH20; pressure support: 5–12cmH20 for tidal volume target: 6–8mL/kg of ideal weight; continuous session. The parameters studied were demographic, clinical, imaging, therapeutic and outcomes. Non-invasive ventilation failure was defined as patient death.


During this period, 09 cases were retained. The average age was 63 years old. A male predominance was found with a sex ratio of 2. Eighty-nine percent (89%) of the cases had comorbidities dominated by high blood pressure (67%) and diabetes (33%). One case had known COPD (11%). Imaging was typical in CT scan with ground glass (100%), condensation (44%), fibrosis (33%), both peripheral and central (78%), diffuse (100%), bilateral (100%); affecting more than 50% (66%) of the lung parenchyma. Non-invasive ventilation was well tolerated in 67% of cases. Non-invasive ventilation was effective in 67% of cases by decreasing respiratory rate (89%), signs of respiratory struggle (56%) and improving hypoxemia (100%). The duration of a session ranged from 12 to 20hours per 24hours. The average total duration of non-invasive ventilation was 5 days ranging from 1 to 11 days. The healing rate was 67% although 83% were discharged with long-term oxygenotherapy and 17% with home non-invasive ventilation. Nevertheless, the death rate was 33.33%.


The occurrence of acute respiratory distress syndrome constitutes the severity of covid-19. Non-invasive ventilation is an alternative to reduce the mortality of patients with acute respiratory distress syndrome.

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© 2022  Publicado por Elsevier Masson SAS.

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Vol 40 - N° 2

P. 135 - février 2023 Regresar al número
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