Initial Emergency Department Mechanical Ventilation Strategies for COVID-19 Hypoxemic Respiratory Failure and Ards
Abstract
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging viral pathogen that causes the novel coronavirus disease of 2019 (COVID-19) and may result in hypoxemic respiratory failure necessitating invasive mechanical ventilation in the most severe cases. Objective: This narrative review provides evidence-based recommendations for the treatment of COVID-19 related respiratory failure requiring invasive mechanical ventilation. Discussion: In severe cases, COVID-19 leads to hypoxemic respiratory failure that may meet criteria for acute respiratory distress syndrome (ARDS). The mainstay of treatment for ARDS includes a lung protective ventilation strategy with low tidal volumes (48 mL/kg predicted body weight), adequate positive end-expiratory pressure (PEEP), and maintaining a plateau pressure of < 30 cm H2O. While further COVID-19 specific studies are needed, current management should focus on supportive care, preventing further lung injury from mechanical ventilation, and treating the underlying cause. Conclusions: This review provides evidence-based recommendations for the treatment of COVID-19 related respiratory failure requiring invasive mechanical ventilation.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 29, 2020
- Accession Number
- AD1113004
Entities
People
- Brit Long
- Mark Ramzy
- Matthew A. Roginski
- Michael Gottlieb
- Skyler Lentz
- Tim Montrief
Organizations
- University of Vermont