Hiệu quả của phương pháp oxy hóa qua màng ngoài cơ thể (ECMO) trong hỗ trợ điều trị hội chứng suy hô hấp cấp nguy kịch trên bệnh nhân Covid

2022 ◽  
Author(s):  
Tuan Anh Truong
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Case Series ◽  
Patient Reports ◽  
Initial Application ◽  
October 17

TÓM TẮT Sự bùng phát của hội chứng viêm đường hô hấp cấp do coronavirus 2 (SARS-CoV-2) nhanh chóng trở thành đại dịch trên toàn thế giới với hơn 40 triệu người mắc và hơn 1 triệu người chết tính đến ngày 17 tháng 10 năm 2020. Nhiều bệnh nhân COVID-19 được báo cáo cho thấy rằng có thể dẫn đến suy hô hấp cấp cần chăm sóc đặc biệt (ICU) và thiết bị hỗ trợ thở và bệnh cảnh có thể nhanh chóng tiến triển thành chứng suy hô hấp cấp (ARDS) với thiếu oxy ở mức độ nặng và gây ra tử vong dù đã có sự hỗ trợ của thiết bị hỗ trợ thở, cả 2 khả năng này thậm chí có thể cùng xảy ra. Các tổ chức quốc tế và các chuyên gia trong lĩnh vực này khuyến nghị sử dụng ECMO cho những bệnh nhân ARDS bị bệnh nặng có COVID-19. Tuy nhiên, tỷ lệ sống sót là rất thấp trong những trường hợp được sử dụng ECMO với COVID-19 trong đợt đầu tiên. Nghiên cứu của chúng tôi nhằm đánh giá kết quả bước đầu ứng dụng kỹ thuật ECMO trong hỗ trợ điều trị hội chứng suy hô hấp cấp nguy kịch trên bệnh nhân COVID-19 tại trung tâm hồi sức bệnh viện Trung ương Huế. ABSTRACT EFFECTIVENESS OF EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) IN THE TREATMENT OF ACUTE RESPIRATORY DISTRESS SYNDROME IN PATIENTS WITH COVID-19 The outbreak of acute respiratory syndrome caused by coronavirus 2 (SARS-CoV-2) quickly developed into a worldwide pandemic with more than 40 million people infected and more than 1 million dead as of October 17, 2020. Numerous patient reports COVID-19 can lead to acute respiratory failure requiring intensive care (ICU) and ventilators, and it can rapidly evolve into a certificate of acute respiratory failure (ARDS) with red oxygen in the heavy and death, despite the protective ventilator, even both. International organizations and experts in the field recommend ECMO for critically ill ARDS patients with COVID-19. However, survival is very low in the ECMO - corrected case series with COVID-19 during the first COVID-19 wave. Our study aimed to evaluate the results of the initial application of transmembrane oxygenation (ECMO) technique in the support of critical acute respiratory distress syndrome on COVID-19 patients at the hospital resuscitation center of Hue central hospital. Keywords: ECMO, ARDS, COVID-19.

Barotrauma during non-invasive ventilation for acute respiratory distress syndrome caused by COVID-19: a balance between risks and benefits

2021 ◽  
Vol 82 (6) ◽  
pp. 1-9
Author(s):  
M Gabrielli ◽  
F Valletta ◽  
F Franceschi ◽  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Ventilatory support is vital for the management of severe forms of COVID-19. Non-invasive ventilation is often used in patients who do not meet criteria for intubation or when invasive ventilation is not available, especially in a pandemic when resources are limited. Despite non-invasive ventilation providing effective respiratory support for some forms of acute respiratory failure, data about its effectiveness in patients with viral-related pneumonia are inconclusive. Acute respiratory distress syndrome caused by severe acute respiratory syndrome-coronavirus 2 infection causes life-threatening respiratory failure, weakening the lung parenchyma and increasing the risk of barotrauma. Pulmonary barotrauma results from positive pressure ventilation leading to elevated transalveolar pressure, and in turn to alveolar rupture and leakage of air into the extra-alveolar tissue. This article reviews the literature regarding the use of non-invasive ventilation in patients with acute respiratory failure associated with COVID-19 and other epidemic or pandemic viral infections and the related risk of barotrauma.

Assessment of Acute Respiratory Failure

2018 ◽  
Author(s):  
Nathan R. Manley ◽  
Martin A Croce
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Lung Injury ◽  
Acute Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Medical Decision ◽  
Surgical Patient ◽  
Respiratory Drive

Acute respiratory failure (ARF) is fundamentally a dysfunction of gas exchange and can be due to either inadequate carbon dioxide elimination causing hypercapnia or poor oxygen exchange and delivery causing hypoxemia. A variety of etiologies exist that cause ARF in the surgical patient, including previous lung disease, such as chronic obstructive pulmonary disease or asthma, neurologic compromise of respiratory drive, nutritional and metabolic derangements that can alter respiratory metabolism and mechanics, direct lung injury, and infection. The type of surgery and the time since surgery are other key factors that influence medical decision making and that will influence priorities in the assessment and management of ARF. This review explores the full spectrum of ARF in the surgical patient, focusing particularly on its assessment and initial management. Figures illustrate algorithms in the approach to the surgical patient with ARF and show example radiographic images of acute respiratory distress syndrome (ARDS), a common complication. Tables summarize indications for emergent intubation, key etiologies of ARF, and the evolving definitions of acute lung injury and ARDS. Key words: acute respiratory distress syndrome, acute respiratory failure, hypercapnia, hypoxemia, mechanical ventilation 

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