SIMEU position paper on non-invasive respiratory support in COVID-19 pneumonia.

Autor: Cosentini R; Emergency Dept, ASST Papa Giovanni XXIII, Bergamo, Italy. rcosentini@asst-pg23.it., Groff P; Pronto Soccorso e Osservazione Breve, Perugia, AO, Italy., Brambilla AM; Emergency Medicine Unit, Luigi Sacco Hospital, ASST FBF Sacco, Milan, Italy., Camajori Todeschini R; Emergency Medicine, San Giovanni di Dio Hospital, Florence, Italy., Gangitano G; Emergency Medicine, Ospedale Infermi Rimini, AUSL Romagna, Rimini, Italy., Ingrassia S; Emergency Medicine Unit, Luigi Sacco Hospital, ASST FBF Sacco, Milan, Italy., Marino R; Emergency Medicine, Sant'Andrea Hospital, Vercelli, Italy., Nori F; Emergency Room, Emergency Care Unit, Santa Maria Della Scaletta Hospital, Imola, Italy., Pagnozzi F; Internal Medicine, Ospedale Civico di Chivasso, ASL TO4, Turin, Italy., Panero F; MECAU 2, Pronto Soccorso e Area Critica, ASL Città di Torino, Turin, Italy., Ferrari R; Emergency Room, Emergency Care Unit, Santa Maria Della Scaletta Hospital, Imola, Italy.
Jazyk: angličtina
Zdroj: Internal and emergency medicine [Intern Emerg Med] 2022 Jun; Vol. 17 (4), pp. 1175-1189. Date of Electronic Publication: 2022 Feb 01.
DOI: 10.1007/s11739-021-02906-6
Abstrakt: The rapid worldwide spread of the Coronavirus disease (COVID-19) crisis has put health systems under pressure to a level never experienced before, putting intensive care units in a position to fail to meet an exponentially growing demand. The main clinical feature of the disease is a progressive arterial hypoxemia which rapidly leads to ARDS which makes the use of intensive care and mechanical ventilation almost inevitable. The difficulty of health systems to guarantee a corresponding supply of resources in intensive care, together with the uncertain results reported in the literature with respect to patients who undergo early conventional ventilation, make the search for alternative methods of oxygenation and ventilation and potentially preventive of the need for tracheal intubation, such as non-invasive respiratory support techniques particularly valuable. In this context, the Emergency Department, located between the area outside the hospital and hospital ward and ICU, assumes the role of a crucial junction, due to the possibility of applying these techniques at a sufficiently early stage and being able to rapidly evaluate their effectiveness. This position paper describes the indications for the use of non-invasive respiratory support techniques in respiratory failure secondary to COVID-19-related pneumonia, formulated by the Non-invasive Ventilation Faculty of the Italian Society of Emergency Medicine (SIMEU) on the base of what is available in the literature and on the authors' direct experience. Rationale, literature, tips & tricks, resources, risks and expected results, and patient interaction will be discussed for each one of the escalating non-invasive respiratory techniques: standard oxygen, HFNCO, CPAP, NIPPV, and awake self-repositioning. The final chapter describes our suggested approach to the failing patient.
(© 2022. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)
Databáze: MEDLINE
Externí odkaz: