scholarly journals Use of non-invasive ventilation in acute respiratory failure due to SARS-CoV-2 pneumonia: typing of patients and choice of respiratory support, the role of internal medicine

2020 ◽  
Author(s):  
Federico Lari ◽  
Fabrizio Giostra ◽  
Stefania Guerrini
Keyword(s):  
Respiratory Failure ◽  
De Novo ◽  
Respiratory Support ◽  
Invasive Ventilation ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Severe Acute Respiratory Infection ◽  
Prognostic Stratification

The use of non-invasive ventilation (NIV) during de novo acute hypoxemic respiratory failure is not recommended by the guidelines because NIV does not improve the prognosis. With the advent of the new coronavirus, many cases of acute hypoxemic respiratory failure associated with the infection (severe acute respiratory infection) have been observed: data are missing regarding the use of NIV in this particular clinical condition, but a correct typing of patients based on different clinical, pathophysiological and radiological characteristics, could help in prognostic stratification and in the choice of respiratory support (invasive versus non-invasive). During NIV in these patients particular attention is paid to the possibility of environmental dissemination of the virus and consequently adequate technical precautions are taken.

scholarly journals Prolonged non-invasive respiratory support in a COVID-19 patient with severe acute hypoxemic respiratory failure

2021 ◽  
Author(s):  
Andrea Lanza ◽  
Maurizio Sommariva ◽  
Sara Mariani ◽  
Gabriela Ferreyra ◽  
Giuliana Enrica Stagni ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Ventilatory Support ◽  
Respiratory Support ◽  
Low Flow ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Non Invasive ◽  
High Dependency ◽  
Non Invasive Ventilation ◽  
Experienced Team

A pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 was declared in 2020. Severe cases were characterized by the development of acute hypoxemic respiratory failure (AHRF) requiring advanced respiratory support. However, intensive care units (ICU) were saturated, and many patients had to be treated out of ICU. This case describes a 75-year-old man affected by AHRF due to Coronavirus Disease 2019 (COVID-19), hospitalized in a high-dependency unit, with PaO2/FiO2 <100 for 28 consecutive days. An experienced team with respiratory physiotherapists was in charge of the noninvasive ventilatory support (NIVS). The patient required permanent NIVS with continuous positive airway pressure, non-invasive ventilation, high flow nasal oxygen and body positioning. He was weaned from NIVS after 37 days and started exercise training afterwards. The patient was discharged at home with low-flow oxygen therapy. This case represents an example of a successful treatment of AHRF with the still controversial noninvasive respiratory support in one patient with COVID-19.

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