Strategies before Intubation in COVID-19: An Evidential Update

ABSTRACT

The coronavirus disease-19 (COVID-19) is impacting large patient populations, resulting in respiratory compromise, necessitating artificial respiratory supports. Early treatment modalities for severe respiratory failure during the pandemic focused on early intubation and invasive ventilation, as this was considered to be more effective than noninvasive respiratory strategies. However, emerging evidence proved that noninvasive respiratory supports such as noninvasive ventilation, high flow nasal cannula along with prone positioning might have a more significant and positive role than initially thought during the pandemic. Reflective evidence also suggests the utility of noninvasive respiratory supports as appropriate bridging adjuncts in the early stages of the disease process and has the potential to prevent intubation or invasive ventilation. This narrative review focusses on various strategies that are attempted in COVID-19 patients to avoid endotracheal intubation.