Title:Efficacy of BAINS Circuit in Treating Critically Ill Hypoxemic COVID-19
Patients During the Second Wave of the Pandemic in India
Volume: 17
Issue: 2
Author(s): Vidya A. Patil, Saikrishna Prasad R., Shivanand L.K., Renuka Holyachi, Kusal K. Das*Vijaykumar T.K.
Affiliation:
- Department of Physiology, Laboratory of Vascular
Physiology and Medicine, Shri B.M.Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be
University), Vijayapur-586103, Karnataka, India
Keywords:
COVID-19, comorbidities, respiratory failure, Bains circuit, lung, inflammation.
Abstract:
Background: The COVID-19 pandemic has encouraged doctors to look for novel ways
of treating patients with respiratory failure due to the limited availability of ventilators and highflow
nasal cannula. The study aims to assess the efficacy of using the Bains circuit as an alternative
to HFNC and NIV as life-saving tools in patients with respiratory failure during the second wave
of the COVID-19 pandemic in India.
Methods: This is a prospective interventional study carried out in the intensive care unit of Shri
B.M Patil Medical College Hospital and Research Centre, Vijayapur, India, from May 2021 to
June 2021. All patients (n=90) with respiratory failure not responding to therapy with an oxygen
mask were included. Patients were placed on Bain circuits, one end connected to a non-invasive
ventilation mask fitted to the face of the patients, and the other end connected to a central oxygen
port. Patients’ vital parameters were assessed on an hourly basis. The blood gas analyses were
done before and after using Bains.
Results: The study showed diabetes (33.4%), hypertension (22.2%), and diabetes with
hypertension (11.1%) as comorbid factors among the ICU admitted patients. The results from the
arterial blood gas analyses showed a statistically significant increase in Sp02 (%) and a decrease in
respiratory rate (cycles/min) in the patients after being kept on Bains (p<0.05). Further, it showed
that 72% of ICU patients with 70-79% Sp02 had a recovery by using Bains. The overall outcome
of ICU admitted COVID-19 patients on Bains showed that 38.9% of patients improved and were
shifted to 02/NRBM masks.
Conclusion: The study highlights a novel concept of using the Bains circuit as an effective
alternative to HFNC and NIV for oxygenation in critically ill COVID-19 patients during scarcity
of NIV and HFNC at the peak of the pandemic.
