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Managing Severe Hypoxic Respiratory Failure in COVID-19.
Smith, Lane M; Glauser, Jonathan M.
  • Smith LM; Division of Critical Care Medicine, Department of Anesthesiology, University of Michigan Health System, 4172 Cardiovascular Center, 1500 East Medical Center Dr., SPC 5861, Ann Arbor, MI 48109-5861 USA.
  • Glauser JM; Department of Emergency Medicine, MetroHealth System and Case Western Reserve University, Cleveland, OH 44109 USA.
Curr Emerg Hosp Med Rep ; 10(3): 31-35, 2022.
Article in English | MEDLINE | ID: covidwho-1943522
ABSTRACT
Purpose of Review Adult respiratory distress syndrome is a life-threatening complication from severe COVID-19 infection resulting in severe hypoxic respiratory failure. Strategies at improving oxygenation have evolved over the course of the pandemic. Recent

Findings:

Although non-invasive respiratory support reduces the need for intubation, a significant number of patients with COVID-19 progress to invasive mechanical ventilation. Once intubated, a lung protective ventilation strategy should be employed that limits tidal volumes to 6 ml/kg of predicted body weight and employs sufficient positive end-expiratory pressure to maximize oxygen delivery while minimizing the fraction of inspired oxygen. Intermittent prone positioning is effective at improving survival, and there is a growing body of evidence that it can be safely performed in spontaneously breathing patients to reduce the need for invasive mechanical ventilation. Inhaled pulmonary vasodilators have not been shown to improve survival or cost-effectiveness in COVID-19 and should be used selectively.

Summary:

Finally, the best outcomes are likely achieved at centers with experience at severe ARDS management and protocols for escalation of care.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal: Curr Emerg Hosp Med Rep Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal: Curr Emerg Hosp Med Rep Year: 2022 Document Type: Article