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BackgroundContinuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO) have been used to manage hypoxaemic respiratory failure secondary to coronavirus disease 2019 (COVID-19) pneumonia. Limited data are available for patients treated with noninvasive respiratory support outside of the intensive care setting.MethodsIn this single-centre observational study we observed the characteristics, physiological observations, laboratory tests and outcomes of all consecutive patients with COVID-19 pneumonia between April 2020 and March 2021 treated with noninvasive respiratory support outside of the intensive care setting.ResultsWe report the outcomes of 140 patients (mean±sd age: 71.2±11.1, 65% male (n=91)) treated with CPAP/HFNO outside of the intensive care setting. Overall mortality was 59% and was higher in those deemed unsuitable for mechanical ventilation (72%). The mean age of survivors was significantly lower than those who died (66.1 versus 74.4 years, pversus 4, pConclusionsCPAP and HFNO delivered outside of the intensive care setting are viable treatment options for patients with hypoxaemic respiratory failure secondary to COVID-19 pneumonia, including those considered unsuitable for invasive mechanical ventilation. This provides an opportunity to safeguard intensive care capacity for COVID-19 patients requiring invasive mechanical ventilation.

Introduction: BPD is the leading cause of chronic lung disease in infancy and the main reason for long-term home oxygen therapy (LTOT) in children. Babies are weaned off LTOT by undertaking home oximetry studies if they meet targets. Normal oximetry values using modern pulse oximeter with motion artefact extraction technology have been described recently (Evans et. al, Archives of Disease in Childhood, 103, pp.868-872; Wellington et. al, Acta Paediatrica, 107(8), pp.1362-1369. 2018) and should be used to guide targets for weaning. Aims: This study was conducted to describe the oximetry parameters at oxygen cessation (SpO2TARGETS) babies with BPD who had their LTOT weaned off in a structured manner. Setting: Tertiary Paediatric Respiratory service, Nottingham, UK Methods: Retrospective case note review of 243 of babies with BPD born between 2008-2018 and discharged home in Oxygen. The saturation monitors were changed from Ohmeda to Masimo in 2017 and therefore, comparison between SpO2TARGETS by different monitors at cessation was also made. Results: Conclusion: We are pleased to report no difference in the SpO2TARGETS when weaning LTOT using different monitors. Use of artefact resistant monitors along with flow rate per weight based weaning (data not shown) has led to reduction of duration of LTOT.

Summary Objective To assess and quantify singers’ strategies for adding air to phonation to sound “breathy” in a healthy manner Study design Case-control study with 20 professional singers. Methods Twenty singers were recorded performing sustained vowels in the Complete Vocal Technique Neutral vocal mode with and without audible air added to the voice by means of laryngostroboscopic imaging using a videonasoendoscopic camera system, electroglottography, long-term average spectrum, as well as acoustic signals and audio perception. Singers completed Voice Handicap Index and Reflux Symptom Index questionnaires prior to examination. Results Air added to the voice resulted in an expected glottal gap along the length of the vocal folds, with little to no further difference in the supraglottic area, as compared with the Neutral phonation. Air added resulted in lowered Qx, mean Sound Pressure Level, and Cepstral Peak Prominence, but higher Harmonics-to-Noise Ratio, Jitter, and Shimmer, with decreased energy at the fundamental frequency. Adding audible air to the phonation did not exhibit similar effects on acoustics for males and females. Also, for females, H1–H2 difference decreased with air added, while it increased for males. Conclusion Singers produce an audible airy phonation similar yet significantly different to the breathy phonation reported for both healthy and pathological speakers.