Mechanical Ventilation in COVID

ABSTRACT

From the start of the pandemic, amid the frequency of cases with COVID-19 associated respiratory failure, mechanical ventilation has been the object of controversy. Reports associating its use with higher mortality, likely reflecting the severity of an unknown illness devastating the entire world, as well as the turmoil caused by the lack of sufficient equipment to supply the increasing demands in our hospitals, both were points of attention for media and public in general. However, from the clinical perspective, the need to apply different methods or to deviate from stablished guidelines to be able to adequately support these patients, was soon noticed. Multiple publications were guiding clinicians in the obscured territory of the unknown disease and to its variable impact on the respiratory system. This chapter aims to summarize the knowledge acquired throughout the pandemic, describing some of the elements of COVID-19 respiratory failure as well as its management with mechanical ventilation. The chapter recovers some of the increasing information appearing almost daily in the literature. We recognize that given the changing nature of the disease and the progressive knowledge of the same, some of the concepts covered in this chapter might be subject of some review or modification at the moment of the publication. We, the authors, have attempted to summarize the existing evidence and to maintain a basic conceptual approach to the management of COVID-19 respiratory failure. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.