Non-Invasive Respiratory Support During Covid-19 Pandemic |Biomedgrid

Acute respiratory failure frequently occurs in severe COVID-19 and requires ventilator support. However, during the first wave of the pandemic, conventional resources for critically ill patients were insufficient in many centers. Therefore, an alternative strategy based on the use of non-invasive respiratory support (NIRS), and especially continuous positive airway pressure (CPAP), have been massively employed, either as a definitive therapy or as a bridge for orotracheal intubation. The results of this strategy have been excellent. If patients are carefully selected and monitored and NIRS is managed by an expert team in an appropriate environment, the vast majority of patients survive, avoiding intubation in most cases, and even decreasing the possibility of a self-inflicted lung injury (SILI). Moreover, there is evidence that with these techniques the risk of aerosolization is low. Nowadays, CPAP is considered the best option for most patients, with BiPAP being especially recommended in those with previous thoracic diseases or chronic hypercapnia. We conclude that NIRS techniques can be used in the initial care of most patients with severe respiratory failure from COVID-19 pneumonia and/or thromboembolism. To achieve the best results, intermediate care units, where specialized respiratory support can be provided, are the most appropriate framework.