Clinical update on COVID-19 for the emergency clinician: Airway and resuscitation

Chavez, Summer; Brady, William J.; Gottlieb, Michael; Carius, Brandon M; Liang, Stephen Y.; Koyfman, Alex; Long, Brit

doi:10.1016/j.ajem.2022.05.011

Cited by 3 publications

(5 citation statements)

References 123 publications

(173 reference statements)

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“…These forces may damage the alveolar-capillary barrier and cause the release of mediators and the mobilization of inflammatory cells that further injure the barrier. Therefore, trying to keep the patients oxygenated and at the same time avoid MV or reduce its duration is one of the problems doctors have to deal with daily [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Exploiting Bacteria for Improving Hypoxemia of COVID-19 Patients

et al. 2022

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Background: Although useful in the time-race against COVID-19, CPAP cannot provide oxygen over the physiological limits imposed by severe pulmonary impairments. In previous studies, we reported that the administration of the SLAB51 probiotics reduced risk of developing respiratory failure in severe COVID-19 patients through the activation of oxygen sparing mechanisms providing additional oxygen to organs critical for survival. Methods: This “real life” study is a retrospective analysis of SARS-CoV-2 infected patients with hypoxaemic acute respiratory failure secondary to COVID-19 pneumonia undergoing CPAP treatment. A group of patients managed with ad interim routinely used therapy (RUT) were compared to a second group treated with RUT associated with SLAB51 oral bacteriotherapy (OB). Results: At baseline, patients receiving SLAB51 showed significantly lower blood oxygenation than controls. An opposite condition was observed after 3 days of treatment, despite the significantly reduced amount of oxygen received by patients taking SLAB51. At 7 days, a lower prevalence of COVID-19 patients needing CPAP in the group taking probiotics was observed. The administration of SLAB51 is a complementary approach for ameliorating oxygenation conditions at the systemic level. Conclusion: This study proves that probiotic administration results in an additional boost in alleviating hypoxic conditions, permitting to limit on the use of CPAP and its contraindications.

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Section: Introductionmentioning

confidence: 99%

Exploiting Bacteria for Improving Hypoxemia of COVID-19 Patients

et al. 2022

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“…We read the article by Chavez et al with great interest and appreciate the authors' efforts to provide resuscitation strategies and airway management techniques in patients with COVID-19 for emergency medicine clinicians. [ 1 ] Chavez et al recommend treating intubated COVID-19 patients with ARDS at higher PEEP than lower PEEP as in other ARDS.…”

mentioning

confidence: 99%

COVID-19 pneumonia with Fontan-circulation that resulted in circulatory collapse and hypoxemia due to high PEEP

Oe¹,

Shima²,

Ueda³

2023

The American Journal of Emergency Medicine

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“…We thank the authors for their response to our article “Clinical update on COVID-19 for the emergency clinician: Airway and resuscitation.” [ 1 ] In the authors' letter, they describe the case of a young man with several cardiac surgeries for a ventricular septal defect, pulmonary artery stenosis, and transposition of the great vessels admitted for COVID-19. He underwent gradual escalation of respiratory care, with hemodynamic compromise following endotracheal intubation.…”

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confidence: 99%

“…Importantly, we advocate for monitoring additional measures of resuscitation beyond oxygen saturation alone, including patient symptoms, respiratory rate, and respiratory effort. Patients with COVID-19 may present with hypoxemia but no increased work of breathing [ 1 ]. Respiratory management can start with nasal cannula, followed by facemask, Venturi mask, high flow nasal cannula, and bilevel positive airway pressure or continuous positive airway pressure ventilation.…”

mentioning

confidence: 99%

“…Respiratory management can start with nasal cannula, followed by facemask, Venturi mask, high flow nasal cannula, and bilevel positive airway pressure or continuous positive airway pressure ventilation. Rather than solely targeting oxygen saturation, assessing patient comfort and work of breathing is important, and we believe targeting an oxygen saturation ≥ 90% is reasonable [ 1 ]. In patients with complex physiology, other measures including mean pulmonary venous wedge pressure, pulmonary vascular resistance, arterial oxygen saturation, and partial pressure of oxygen can be utilized [ [2] , [3] , [4] , [5] ].…”

mentioning

confidence: 99%

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