tetano
Editor, Senior Moderator
Am J Emerg Med
. 2020 Jul 4;S0735-6757(20)30586-6.
doi: 10.1016/j.ajem.2020.06.082. Online ahead of print.
Initial emergency department mechanical ventilation strategies for COVID-19 hypoxemic respiratory failure and ARDS
Skyler Lentz[SUP] 1 [/SUP], Matthew A Roginski[SUP] 2 [/SUP], Tim Montrief[SUP] 3 [/SUP], Mark Ramzy[SUP] 4 [/SUP], Michael Gottlieb[SUP] 5 [/SUP], Brit Long[SUP] 6 [/SUP]
Affiliations
Abstract
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging viral pathogen that causes the novel coronavirus disease of 2019 (COVID-19) and may result in hypoxemic respiratory failure necessitating invasive mechanical ventilation in the most severe cases.
Objective: This narrative review provides evidence-based recommendations for the treatment of COVID-19 related respiratory failure requiring invasive mechanical ventilation.
Discussion: In severe cases, COVID-19 leads to hypoxemic respiratory failure that may meet criteria for acute respiratory distress syndrome (ARDS). The mainstay of treatment for ARDS includes a lung protective ventilation strategy with low tidal volumes (4-8 mL/kg predicted body weight), adequate positive end-expiratory pressure (PEEP), and maintaining a plateau pressure of < 30 cm H[SUB]2[/SUB]O. While further COVID-19 specific studies are needed, current management should focus on supportive care, preventing further lung injury from mechanical ventilation, and treating the underlying cause.
Conclusions: This review provides evidence-based recommendations for the treatment of COVID-19 related respiratory failure requiring invasive mechanical ventilation.
Keywords: Acute respiratory distress syndrome; COVID-19; Lung protective strategy; Mechanical ventilation; Respiratory failure; SARS-CoV-2.
. 2020 Jul 4;S0735-6757(20)30586-6.
doi: 10.1016/j.ajem.2020.06.082. Online ahead of print.
Initial emergency department mechanical ventilation strategies for COVID-19 hypoxemic respiratory failure and ARDS
Skyler Lentz[SUP] 1 [/SUP], Matthew A Roginski[SUP] 2 [/SUP], Tim Montrief[SUP] 3 [/SUP], Mark Ramzy[SUP] 4 [/SUP], Michael Gottlieb[SUP] 5 [/SUP], Brit Long[SUP] 6 [/SUP]
Affiliations
- PMID: 33071092
- PMCID: PMC7335247
- DOI: 10.1016/j.ajem.2020.06.082
Abstract
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging viral pathogen that causes the novel coronavirus disease of 2019 (COVID-19) and may result in hypoxemic respiratory failure necessitating invasive mechanical ventilation in the most severe cases.
Objective: This narrative review provides evidence-based recommendations for the treatment of COVID-19 related respiratory failure requiring invasive mechanical ventilation.
Discussion: In severe cases, COVID-19 leads to hypoxemic respiratory failure that may meet criteria for acute respiratory distress syndrome (ARDS). The mainstay of treatment for ARDS includes a lung protective ventilation strategy with low tidal volumes (4-8 mL/kg predicted body weight), adequate positive end-expiratory pressure (PEEP), and maintaining a plateau pressure of < 30 cm H[SUB]2[/SUB]O. While further COVID-19 specific studies are needed, current management should focus on supportive care, preventing further lung injury from mechanical ventilation, and treating the underlying cause.
Conclusions: This review provides evidence-based recommendations for the treatment of COVID-19 related respiratory failure requiring invasive mechanical ventilation.
Keywords: Acute respiratory distress syndrome; COVID-19; Lung protective strategy; Mechanical ventilation; Respiratory failure; SARS-CoV-2.