New and personalized ventilatory strategies in patients with COVID-19
Coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus and may lead to severe respiratory failure and the need for mechanical ventilation (MV). At hospital admission, patients can present with severe hypoxemia and dyspnea requiring increasi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1194773/full |
| _version_ | 1827935333799428096 |
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| author | Lucas Rodrigues de Moraes Chiara Robba Denise Battaglini Paolo Pelosi Patricia R. M. Rocco Pedro Leme Silva |
| author_facet | Lucas Rodrigues de Moraes Chiara Robba Denise Battaglini Paolo Pelosi Patricia R. M. Rocco Pedro Leme Silva |
| author_sort | Lucas Rodrigues de Moraes |
| collection | DOAJ |
| description | Coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus and may lead to severe respiratory failure and the need for mechanical ventilation (MV). At hospital admission, patients can present with severe hypoxemia and dyspnea requiring increasingly aggressive MV strategies according to the clinical severity: noninvasive respiratory support (NRS), MV, and the use of rescue strategies such as extracorporeal membrane oxygenation (ECMO). Among NRS strategies, new tools have been adopted for critically ill patients, with advantages and disadvantages that need to be further elucidated. Advances in the field of lung imaging have allowed better understanding of the disease, not only the pathophysiology of COVID-19 but also the consequences of ventilatory strategies. In cases of refractory hypoxemia, the use of ECMO has been advocated and knowledge on handling and how to personalize strategies have increased during the pandemic. The aims of the present review are to: (1) discuss the evidence on different devices and strategies under NRS; (2) discuss new and personalized management under MV based on the pathophysiology of COVID-19; and (3) contextualize the use of rescue strategies such as ECMO in critically ill patients with COVID-19. |
| first_indexed | 2024-03-13T07:51:39Z |
| format | Article |
| id | doaj.art-04623d7551a14c9b8626eeb2f0c781eb |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-13T07:51:39Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-04623d7551a14c9b8626eeb2f0c781eb2023-06-02T10:54:59ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-06-011010.3389/fmed.2023.11947731194773New and personalized ventilatory strategies in patients with COVID-19Lucas Rodrigues de Moraes0Chiara Robba1Denise Battaglini2Paolo Pelosi3Patricia R. M. Rocco4Pedro Leme Silva5Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, BrazilUnit of Anaesthesia and Intensive Care, San Martino Hospital (IRCCS), Genoa, ItalyUnit of Anaesthesia and Intensive Care, San Martino Hospital (IRCCS), Genoa, ItalyUnit of Anaesthesia and Intensive Care, San Martino Hospital (IRCCS), Genoa, ItalyLaboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, BrazilLaboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, BrazilCoronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus and may lead to severe respiratory failure and the need for mechanical ventilation (MV). At hospital admission, patients can present with severe hypoxemia and dyspnea requiring increasingly aggressive MV strategies according to the clinical severity: noninvasive respiratory support (NRS), MV, and the use of rescue strategies such as extracorporeal membrane oxygenation (ECMO). Among NRS strategies, new tools have been adopted for critically ill patients, with advantages and disadvantages that need to be further elucidated. Advances in the field of lung imaging have allowed better understanding of the disease, not only the pathophysiology of COVID-19 but also the consequences of ventilatory strategies. In cases of refractory hypoxemia, the use of ECMO has been advocated and knowledge on handling and how to personalize strategies have increased during the pandemic. The aims of the present review are to: (1) discuss the evidence on different devices and strategies under NRS; (2) discuss new and personalized management under MV based on the pathophysiology of COVID-19; and (3) contextualize the use of rescue strategies such as ECMO in critically ill patients with COVID-19.https://www.frontiersin.org/articles/10.3389/fmed.2023.1194773/fullCOVID-19noninvasive respiratory supportinvasive mechanical ventilationprone positionrecruitment maneuversextracorporeal membrane oxygenation |
| spellingShingle | Lucas Rodrigues de Moraes Chiara Robba Denise Battaglini Paolo Pelosi Patricia R. M. Rocco Pedro Leme Silva New and personalized ventilatory strategies in patients with COVID-19 Frontiers in Medicine COVID-19 noninvasive respiratory support invasive mechanical ventilation prone position recruitment maneuvers extracorporeal membrane oxygenation |
| title | New and personalized ventilatory strategies in patients with COVID-19 |
| title_full | New and personalized ventilatory strategies in patients with COVID-19 |
| title_fullStr | New and personalized ventilatory strategies in patients with COVID-19 |
| title_full_unstemmed | New and personalized ventilatory strategies in patients with COVID-19 |
| title_short | New and personalized ventilatory strategies in patients with COVID-19 |
| title_sort | new and personalized ventilatory strategies in patients with covid 19 |
| topic | COVID-19 noninvasive respiratory support invasive mechanical ventilation prone position recruitment maneuvers extracorporeal membrane oxygenation |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1194773/full |
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