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Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
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Mechanical Ventilation for COVID-19 Patients.

Matteo Brioni1, Andrea Meli1, Giacomo Grasselli1,2

  • 1Department of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

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Severe COVID-19 respiratory failure often requires mechanical ventilation (MV) or non-invasive ventilation (NIV). This article reviews NIV and MV settings and usage for hypoxemic patients during the pandemic.

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Area of Science:

  • Critical Care Medicine
  • Pulmonology
  • Infectious Diseases

Background:

  • Acute hypoxemic respiratory failure from SARS-CoV-2 infection frequently necessitates respiratory support.
  • The COVID-19 pandemic led to ICU bed shortages, increasing non-invasive ventilation (NIV) use outside intensive care settings.
  • Awake prone positioning is a common adjunct to NIV for improving oxygenation in COVID-19 patients.

Purpose of the Study:

  • To review the current state of non-invasive ventilation (NIV) and invasive mechanical ventilation (MV) settings.
  • To describe the application of NIV and MV in managing acute hypoxemic respiratory failure in COVID-19 patients.
  • To highlight challenges and considerations related to respiratory support during the pandemic.

Main Methods:

  • Review of current literature and clinical practices regarding NIV and MV in COVID-19.
  • Discussion of ventilation strategies, including awake prone positioning and timing of intubation.
  • Analysis of resource limitations and their impact on ventilation choices.

Main Results:

  • NIV is often used in non-ICU settings for COVID-19 patients due to resource constraints.
  • The optimal timing for intubation and use of neuromuscular blocking agents in COVID-19 remains debated.
  • Avoiding ventilator-induced lung injury is a key goal during mechanical ventilation (MV).

Conclusions:

  • Understanding NIV and MV settings is crucial for managing COVID-19-related respiratory failure.
  • Patient self-induced lung injury and resource availability are important factors influencing outcomes.
  • This review provides insights into the state-of-the-art for respiratory support in COVID-19 patients.