Techniques for Oxygenation and Ventilation in Coronavirus Disease 2019

Abstract

This paper discusses mechanisms of hypoxemia and interventions to oxygenate critically ill patients with COVID-19 which range from nasal cannula to noninvasive and mechanical ventilation. Noninvasive ventilation includes continuous positive airway pressure ventilation (CPAP) and high-flow nasal cannula (HFNC) with or without proning. The evidence for each of these modalities is discussed and thereafter, when to transition to mechanical ventilation (MV). Various techniques of MV, again with and without proning, and rescue strategies which would include extra corporeal membrane oxygenation (ECMO) when it is available and permissive hypoxemia where it is not, are discussed.

Stratification of COVID-19 Patients with Moderate-to-Severe Hypoxemic Respiratory Failure for Response to High-Flow Nasal Cannula: A Retrospective Observational Study

“…Indeed, some studies suggest that HFNC, a relatively new technique that is easy to use and employed also in non-ICU settings, is a better approach to start with for the treatment of mild-to-moderate respiratory failure in COVID-19 patients [21,29,[35][36][37], even in…”

“…Indeed, some studies suggest that HFNC, a relatively new technique that is easy to use and employed also in non-ICU settings, is a better approach to start with for the treatment of mild-to-moderate respiratory failure in COVID-19 patients [21,29,[35][36][37], even in those with a do not intubate order [38]. However, this option does not appear to be applicable to the entire population of COVID-19 patients with moderate-to-severe hypoxemic respiratory failure.…”