ABSTRACT
Lung involvement with differing phenotypes characterizes COVID-19-induced acute respiratory distress syndrome (CARDS). The liberation of these patients from mechanical ventilation has been challenging. Excessive stress and strain following increased respiratory efforts spiral their vulnerable lung tissue into ventilator-induced lung injury vortex. The use of high-flow oxygen therapy via tracheostomy (HFOTTracheal)eases weaning process. As a safe option for both the patient and the healthcare workers, HFOTTracheal was successfully employed to wean two CARDS patients from the mechanical ventilator. How to cite this article: Vadi S, Phadtare S, Shetty K. High-flow Oxygen Therapy via Tracheostomy to Liberate COVID-19-induced ARDS from Invasive Ventilation: A Case Series. Indian J Crit Care Med 2021;25(6):724-728.
ABSTRACT
A 52 year old previously healthy woman from Mumbai presented with fever and jaundice of 10 days duration. At admission, she was jaundiced with tachycardia, tachypnea, hypoxia, hypotension, conjunctival congestion and mild erythematous flush over the skin. She had very high WBC counts and CRP's with direct hyperbilirubinemia and azotemia. Investigations for infectious causes of fever were negative. RT-PCR for SARS-CoV-2 in the nasopharynx was negative. However her SARS-CoV-2 antibodies were reactive. She also had echocardiographic and biochemical evidence of cardiac dysfunction. The diagnosis of Multisystem inflammatory syndrome-Adult (MIS-A) was thus established. She rapidly improved with intravenous immunoglobulin (2â¯gm/kg) and high dose steroids.