“…Most of the data and guidelines are extrapolated from the literature and guidelines on adults with COVID-19, evidence from other viral respiratory infections, and general intensive care management guidelines. 1 39…”
Section: Respiratory Support In Children With Covid-19mentioning
confidence: 99%
“…In critically ill adult patients with COVID-19 in China, the use of NIV and HFNC was about one-third and two-thirds, respectively. 1 The main concern in using these devices was the increased risk of exposure to HCPs due to aerosol generation, if negative pressure rooms are not available. The literature is ambiguous regarding the safety concerns as regards the aerosol generation.…”
Section: Noninvasive Ventilation and Heated Humidified High-flow Nasa...mentioning
confidence: 99%
“…41 Since intubation is an AGP, previous studies on SARS and MERS showed that intubation poses a risk of viral transmission to HCPs. 1 54 Therefore, it is of utmost importance to maintain safety of patient, as well as of HCPs, while performing endotracheal intubation.…”
Section: Endotracheal Intubationmentioning
confidence: 99%
“…According to the initial studies, nearly 3 to 10% of the patients required intensive care unit (ICU) admission. 1 In adult patients, the most common causes of ICU admission were acute hypoxemic respiratory failure with or without severe hypercapnia from acute respiratory distress syndrome (ARDS; 60–70%), followed by shock (30%), myocardial dysfunction (20–30%), and acute kidney injury (AKI; 10–30%). 2 In a review of 55,924 confirmed adult cases from China by the World Health Organization (WHO)–China Joint Mission, 13.8% were classified as severe and 6.1% as critical (respiratory failure, shock, and multiple organ dysfunction syndrome [MODS]).…”
Section: Introductionmentioning
confidence: 99%
“…Since there is no definitive treatment for COVID-19, the only treatment is supportive management of patients with COVID-19. 1 Since lungs are the predominant organs involved in COVID-19, and respiratory support is the most common intervention, it should be provided taking all precautions to limit transmission of virus to health care providers (HCPs) and ensuring safety of the patients.…”
The novel coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is causing significant morbidity and mortality worldwide. The common presentations in children include involvement of respiratory system leading to pneumonia and acute respiratory distress syndrome, as well as multiorgan dysfunction syndrome and multisystem inflammatory syndrome in children (MIS-C). Pediatric COVID-19 is a milder disease as compared with the adults. Also, there is rise in MIS-C cases which is a hyperinflammatory condition temporally associated with SARS-CoV-2. Since respiratory system is predominantly involved, few of these critically ill children often require respiratory support which can range from simple oxygen delivery devices, high-flow nasal cannula (HFNC), noninvasive ventilation (NIV), invasive mechanical ventilation, and extracorporeal membrane oxygenation (ECMO). Most of the oxygen delivery devices and respiratory interventions generate aerosols and pose risk of transmission of virus to health care providers (HCPs). The use of HFNC and NIV should be limited to children with mild respiratory distress preferably in negative pressure rooms and with adequate personnel protective equipments (PPEs). However, there should be low thresholds for intubation and invasive mechanical ventilation in the event of clinical deterioration while on any respiratory support. The principle of providing respiratory support requires special droplet and air-borne precautions to limit exposure or transmission of virus to HCPs and at the same time ensuring safety of the patient.
“…Most of the data and guidelines are extrapolated from the literature and guidelines on adults with COVID-19, evidence from other viral respiratory infections, and general intensive care management guidelines. 1 39…”
Section: Respiratory Support In Children With Covid-19mentioning
confidence: 99%
“…In critically ill adult patients with COVID-19 in China, the use of NIV and HFNC was about one-third and two-thirds, respectively. 1 The main concern in using these devices was the increased risk of exposure to HCPs due to aerosol generation, if negative pressure rooms are not available. The literature is ambiguous regarding the safety concerns as regards the aerosol generation.…”
Section: Noninvasive Ventilation and Heated Humidified High-flow Nasa...mentioning
confidence: 99%
“…41 Since intubation is an AGP, previous studies on SARS and MERS showed that intubation poses a risk of viral transmission to HCPs. 1 54 Therefore, it is of utmost importance to maintain safety of patient, as well as of HCPs, while performing endotracheal intubation.…”
Section: Endotracheal Intubationmentioning
confidence: 99%
“…According to the initial studies, nearly 3 to 10% of the patients required intensive care unit (ICU) admission. 1 In adult patients, the most common causes of ICU admission were acute hypoxemic respiratory failure with or without severe hypercapnia from acute respiratory distress syndrome (ARDS; 60–70%), followed by shock (30%), myocardial dysfunction (20–30%), and acute kidney injury (AKI; 10–30%). 2 In a review of 55,924 confirmed adult cases from China by the World Health Organization (WHO)–China Joint Mission, 13.8% were classified as severe and 6.1% as critical (respiratory failure, shock, and multiple organ dysfunction syndrome [MODS]).…”
Section: Introductionmentioning
confidence: 99%
“…Since there is no definitive treatment for COVID-19, the only treatment is supportive management of patients with COVID-19. 1 Since lungs are the predominant organs involved in COVID-19, and respiratory support is the most common intervention, it should be provided taking all precautions to limit transmission of virus to health care providers (HCPs) and ensuring safety of the patients.…”
The novel coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is causing significant morbidity and mortality worldwide. The common presentations in children include involvement of respiratory system leading to pneumonia and acute respiratory distress syndrome, as well as multiorgan dysfunction syndrome and multisystem inflammatory syndrome in children (MIS-C). Pediatric COVID-19 is a milder disease as compared with the adults. Also, there is rise in MIS-C cases which is a hyperinflammatory condition temporally associated with SARS-CoV-2. Since respiratory system is predominantly involved, few of these critically ill children often require respiratory support which can range from simple oxygen delivery devices, high-flow nasal cannula (HFNC), noninvasive ventilation (NIV), invasive mechanical ventilation, and extracorporeal membrane oxygenation (ECMO). Most of the oxygen delivery devices and respiratory interventions generate aerosols and pose risk of transmission of virus to health care providers (HCPs). The use of HFNC and NIV should be limited to children with mild respiratory distress preferably in negative pressure rooms and with adequate personnel protective equipments (PPEs). However, there should be low thresholds for intubation and invasive mechanical ventilation in the event of clinical deterioration while on any respiratory support. The principle of providing respiratory support requires special droplet and air-borne precautions to limit exposure or transmission of virus to HCPs and at the same time ensuring safety of the patient.
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