ABSTRACT
The disease caused by the new SARS-CoV-2 can elicit a violent, dysregulated host immune response that can lead to severe results in most of these older patients as ARDS, multiple-organ failure, and death. Acute respiratory distress syndrome (ARDS) is defined as hypoxemia secondary to a rapid onset of non-cardiogenic pulmonary edema. The airway management in a patient with COVID-19 should be carried out considering several aspects. Once it is decided to intubate the patient, use a rapid induction sequence. When signs of respiratory distress are associated with severe hypoxemia, patients should be managed as soon as possible according to the pulmonary phenotypes;however, management of mechanical ventilation must be personalized;if possible, use low tidal volume with 6 mL/kg of predicted body weight. There is no consensus regarding the best PEEP value;several guidelines recommended keeping Pplat 30 cmH2O in patients with ARDS. There are no available studies that describe the clinical evolution of COVID-19 patients ventilated in the prone position;intermittent doses of neuromuscular blocking agents to facilitate lung-protective ventilation, and tracheostomy, remain necessary in some patients with COVID-19. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.