We should pay close attention to some issues in the process of lung injury therapy of critical severe COVID-19

ABSTRACT

Corona virus disease 2019 (COVID-19) progresses very rapidly and a part of patients' condition quickly deteriorate to a severe type or critical severe type, even died of multiple organ failure. Therapeutic principle of these patients is centered on improving oxygenation and lung protection and multiple organ function support. Respiration support includes high-flow nasal cannula oxygen therapy (HFNC), non-invasive positive pressure ventilation (NIPPV), tracheal cannula with mechanical ventilation and extracorporeal membrane oxygenation (ECMO) and assistance methods including lung recruitment and prone position ventilation. Considering COVID-19 progresses rapidly and is very difficult in respiratory therapy, we should pay close attention to above mentioned methods. In particular, identifying risk factors of treatment failure of HFNC and NIPPV in early phase, applying lung recruitment prudently and active application of turning around and beat back and prone position ventilation to help postural drainage and early tracheal cannula with mechanical ventilation and ECMO would be beneficial to the patients.