Respiratory Support Techniques for COVID-19-Related ARDS in a Sub-Saharan African Country

Globalize the Definition, Localize the Treatment: Increasing Equity and Embracing Heterogeneity on the Road to Precision Medicine for Acute Respiratory Distress Syndrome*

“…Using the “Kigali modification” of the Berlin definition, which incorporates lung ultrasound and oxygen saturation (Sp o 2 )/F io 2 ratio without a PEEP requirement, a 2016 observational study from Rwanda showed that hospital-level incidence of ARDS was relatively high (4%), and survival was poor, with inpatient mortality of 50% (10). COVID-19-related ARDS mortality in LMICs is also substantial, reaching 52% in a multicenter study from Uganda that employed the Kigali modification (11). Due to resource limitations, few, if any patients in these studies would have fulfilled the Berlin definition.…”

The Post Coronavirus Disease-19 Pandora-Box: Future Directions for Critical Care in Low and Medium-Income Countries

“…In addition, compromised oxygen delivery to patients including incorrect clinical use may be harmful to patients who may not be hypoxaemic, for example myocardial infarction patients who are not PCR positive for COVID-19. In a study on respiratory techniques for COVID-19 patients in a sub-Saharan clime by Kwizera et al20 , it was revealed that in COVID-19 associated ARDS, mortality rates were highest in patients receiving non-invasive ventilation (NIV) or intermittent mechanical ventilation (IMV). They opined that because these patients are routinely sedated and usually ventilated in controlled modes made them very vulnerable power cuts and interruptions in pressurized oxygen supply.…”