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Year : 2022  |  Volume : 9  |  Issue : 1  |  Page : 54-59

Utility of bain's circuit to deliver respiratory support in a resource-limited setting during the COVID-19 pandemic

1 Department of Pediatrics, Military Hospital Dehradun, Dehradun, Uttarakhand, India
2 Department of Pediatrics, CLIO Mother and Child Institute, Ludhiana, Punjab, India
3 Department of Anesthesia, Army Hospital Research and Referral, New Delhi, India
4 Department of Transfusion Medicine, SRS Hospitals, Ludhiana, Punjab, India
5 Department of Medicine, Military Hospital Dehradun, Dehradun, Uttarakhand, India

Correspondence Address:
Dr. Mehak Bansal
Senior Consultatnt and Pediatric Intensivist, Clio Mother and Child Institute, Ludhiana, Punjab
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/amit.amit_19_22

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Introduction: Patients with COVID pneumonia, who did not respond to high-flow oxygen by nonrebreathing mask (NRBM), needed additional support to deliver oxygen with pressure. We present our innovation to use Bain's circuit to deliver continuous positive airway pressure (CPAP) along with 100% oxygen in patients with COVID-19 when there was a shortage of respiratory support equipment. Materials and Methods: It is a retrospective observational study conducted at two high-volume, government-designated, tertiary level COVID centers of Northern India, during May and June 2021. After taking informed consent from all patients included in the study, a nonventilated noninvasive ventilation (NIV) mask was used as the interface between Bain's circuit and the patient for making a tight seal. Vital parameters were recorded on admission, before putting the patient on Bain's circuit, at 30 min, and 6 h after the initiation of Bain's circuit. Results: Forty-five patients were enrolled in this study. There was a significant reduction in the work of breathing after the application of Bain's circuit. Vital parameters show improvement of the condition. Sensorium also showed a significant improvement after the application of Bain's circuit. Overall, 40% of patients who received Bain's circuit were weaned off to oxygen by NRBM, 31.1% of patients were bridged to NIV, and 28.9% of patients got intubated. Conclusion: The aim of presenting our experience is to generate interest regarding innovations in the face of crisis which may not be perfect but are practical for the situation. We do not recommend the use of Bain's circuit to provide NIV support under normal circumstances. Further studies are needed to support the use of Bain's circuit with modifications as a CPAP/NIV delivering device in selected patients.

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