Best Pract Res Clin Anaesthesiol .The use of positive end expiratory pressure in patients affected by COVID-19: Time to reconsider the relation between morphology and physiology

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Best Pract Res Clin Anaesthesiol


. 2020 Sep;34(3):561-567.
doi: 10.1016/j.bpa.2020.07.007. Epub 2020 Jul 18.
The use of positive end expiratory pressure in patients affected by COVID-19: Time to reconsider the relation between morphology and physiology


Gaetano Perchiazzi ¹ , Mariangela Pellegrini ² , Elena Chiodaroli ³ , Ivan Urits ⁴ , Alan D Kaye ⁵ , Omar Viswanath ⁶ , Giustino Varrassi ⁷ , Filomena Puntillo ⁸



Affiliations

• PMID: 33004167
• DOI: 10.1016/j.bpa.2020.07.007

Abstract

Coronavirus disease 2019 (COVID-19) is a new disease with different phases that can be catastrophic for subpopulations of patients with cardiovascular and pulmonary disease states at baseline. Appreciation for these different phases and treatment modalities, including manipulation of ventilatory settings and therapeutics, has made it a less lethal disease than when it emerged earlier this year. Different aspects of the disease are still largely unknown. However, laboratory investigation and clinical course of the COVID-19 show that this new disease is not a typical acute respiratory distress syndrome process, especially during the first phase. For this reason, the best strategy to be applied is to treat differently the single phases and to support the single functions of the failing organs as they appear.

Keywords: ARDS; PEEP; cardiovascular disease; lung physiology.