High-Flow, Noninvasive Ventilation and Awake (Nonintubation) Proning in Patients With Coronavirus Disease 2019 With Respiratory Failure
| Autor: | Nicholas S. Hill, Suhail Raoof, Charles M. Carpati, Stefano Nava |
|---|---|
| Přispěvatelé: | Raoof S., Nava S., Carpati C., Hill N.S. |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty helmet mask Infectious Disease Transmission Patient-to-Professional high-flow nasal cannula Coronavirus disease 2019 (COVID-19) medicine.medical_treatment Pneumonia Viral Critical Care and Intensive Care Medicine medicine.disease_cause Patient Positioning coronavirus disease 2019 03 medical and health sciences 0302 clinical medicine awake proning Intubation Intratracheal Prone Position medicine Cannula Intubation In patient 030212 general & internal medicine Intensive care medicine Noninvasive Ventilation Betacoronaviru Pandemic Coronavirus Infection SARS-CoV-2 business.industry Oxygen Inhalation Therapy COVID-19 Wakefulne Respiration Artificial Prone position 030228 respiratory system Respiratory failure Noninvasive ventilation Respiratory Insufficiency Cardiology and Cardiovascular Medicine business Nasal cannula Human |
| Zdroj: | Chest |
| ISSN: | 0012-3692 |
| DOI: | 10.1016/j.chest.2020.07.013 |
| Popis: | The coronavirus disease 2019 pandemic will be remembered for the rapidity with which it spread, the morbidity and mortality associated with it, and the paucity of evidence-based management guidelines. One of the major concerns of hospitals was to limit spread of infection to health-care workers. Because the virus is spread mainly by respiratory droplets and aerosolized particles, procedures that may potentially disperse viral particles, the so-called “aerosol-generating procedures” were avoided whenever possible. Included in this category were noninvasive ventilation (NIV), high-flow nasal cannula (HFNC), and awake (nonintubated) proning. Accordingly, at many health-care facilities, patients who had increasing oxygen requirements were emergently intubated and mechanically ventilated to avoid exposure to aerosol-generating procedures. With experience, physicians realized that mortality of invasively ventilated patients was high and it was not easy to extubate many of these patients. This raised the concern that HFNC and NIV were being underutilized to avoid intubation and to facilitate extubation. In this article, we attempt to separate fact from fiction and perception from reality pertaining to the aerosol dispersion with NIV, HFNC, and awake proning. We describe precautions that hospitals and health-care providers must take to mitigate risks with these devices. Finally, we take a practical approach in describing how we use the three techniques, including the common indications, contraindications, and practical aspects of application. |
| Databáze: | OpenAIRE |
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