About: Position Paper for the State-of-the-Art Application of Respiratory Support in Patients with COVID-19

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About: Position Paper for the State-of-the-Art Application of Respiratory Support in Patients with COVID-19 Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Position Paper for the State-of-the-Art Application of Respiratory Support in Patients with COVID-19
Creator	Kluge, Stefan Bauer, Torsten Ewig, Santiago Windisch, Wolfram Pfeifer, Michael Voshaar, Thomas Dellweg, Dominic Geiseler, Jens Heckeshorn, Lepper, Philipp Randerath, Winfried Schönhofer, Bernd Torsten Bauer, Lungenklinik Westhoff, Michael
source	Medline; PMC
abstract	Against the background of the pandemic caused by infection with the SARS-CoV-2 virus, the German Respiratory Society has appointed experts to develop therapy strategies for COVID-19 patients with acute respiratory failure (ARF). Here we present key position statements including observations about the pathophysiology of (ARF). In terms of the pathophysiology of pulmonary infection with SARS-CoV-2, COVID-19 can be divided into 3 phases. Pulmonary damage in advanced COVID-19 often differs from the known changes in acute respiratory distress syndrome (ARDS). Two types (type L and type H) are differentiated, corresponding to early- and late-stage lung damage. This differentiation should be taken into consideration in the respiratory support of ARF. The assessment of the extent of ARF should be based on arterial or capillary blood gas analysis under room air conditions, and it needs to include the calculation of oxygen supply (measured from the variables of oxygen saturation, hemoglobin level, the corrected values of Hüfner's factor, and cardiac output). Aerosols can cause transmission of infectious, virus-laden particles. Open systems or vented systems can increase the release of respirable particles. Procedures in which the invasive ventilation system must be opened and endotracheal intubation carried out are associated with an increased risk of infection. Personal protective equipment (PPE) should have top priority because fear of contagion should not be a primary reason for intubation. Based on the current knowledge, inhalation therapy, nasal high-flow therapy (NHF), continuous positive airway pressure (CPAP), or noninvasive ventilation (NIV) can be performed without an increased risk of infection to staff if PPE is provided. A significant proportion of patients with ARF present with relevant hypoxemia, which often cannot be fully corrected, even with a high inspired oxygen fraction (FiO2) under NHF. In this situation, the oxygen therapy can be escalated to CPAP or NIV when the criteria for endotracheal intubation are not met. In ARF, NIV should be carried out in an intensive care unit or a comparable setting by experienced staff. Under CPAP/NIV, a patient can deteriorate rapidly. For this reason, continuous monitoring and readiness for intubation are to be ensured at all times. If the ARF progresses under CPAP/NIV, intubation should be implemented without delay in patients who do not have a “do not intubate” order.
has issue date	2020-06-19(xsd:dateTime)
bibo:doi	10.1159/000509104
bibo:pmid	32564028
has license	no-cc
sha1sum (hex)	a07e4d7cb22de0fd5f0e13778e598237082fced3
schema:url	https://doi.org/10.1159/000509104
resource representing a document's title	Position Paper for the State-of-the-Art Application of Respiratory Support in Patients with COVID-19
has PubMed Central identifier	PMC7360514
has PubMed identifier	32564028
schema:publication	Respiration
resource representing a document's body	covid:a07e4d7cb22de0fd5f0e13778e598237082fced3#body_text
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