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COVID-19: community CPAP and NIV should be stopped unless medically necessary to support life
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  • Published on:
    Stop respiratory support? - we will take some convincing!
    • Ross J Langley, Consultant in Paediatric Respiratory and Sleep Medicine Royal Brompton Hospital, Department of Respiratory Paediatrics and Sleep Medicine, London, UK
    • Other Contributors:
      • Rishi Pabary, Consultant in Paediatric Respiratory and Sleep Medicine
      • Federica Trucco, Consultant in Paediatric Sleep Medicine
      • Andrew Bush, Professor of Paediatric Respiratory and Sleep Medicine

    Langley RJ*1, Pabary R1, Trucco F1, Bush A1.

    Department of Respiratory Paediatrics and Sleep Medicine, Royal Brompton Hospital, London, UK
    *Corresponding author - rosslangley@nhs.net
    No conflicts of interest

    Dear Editor

    Whilst we recognise the need for caution and careful planning when considering the ongoing use of home non-invasive ventilation (NIV) and continuous positive airway pressure (CPAP) in children during the COVID-19 pandemic, we read with some concern the recent views by Barker et al.1 recommending the discontinuation of respiratory support unless “medically necessary to support life”.

    There is undoubtedly a risk to caregivers and relatives of potential aerosolisation of infectious material. This is true not just of COVID-19, but also potentially harmful viruses such influenza A, respiratory syncytial virus (RSV) and many other respiratory viral pathogens which commonly infect children. This is not a new threat, but a new virus.

    However, advising withdrawal of CPAP/NIV support, which is always prescribed for sound medical reasons in children, is not just misplaced but potentially dangerous.

    Firstly, there is a real danger in providing such advice at time of crisis when one cannot fully assess or appreciate the impact of withdrawing treatment on “peacetime” health. Children requiring respiratory support often struggle to comply and reduced use over time would undoubte...

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    Conflict of Interest:
    None declared.