Evolving oxygenation management reasoning in COVID-19

Diagnosis (Berl). 2020 Nov 18;7(4):381-383. doi: 10.1515/dx-2020-0099.

Abstract

The initial phase of the SARS-CoV-2 pandemic in the United States saw rapidly-rising patient volumes along with shortages in personnel, equipment, and intensive care unit (ICU) beds across many New York City hospitals. As our hospital wards quickly filled with unstable, hypoxemic patients, our hospitalist group was forced to fundamentally rethink the way we triaged and managed cases of hypoxemic respiratory failure. Here, we describe the oxygenation protocol we developed and implemented in response to changing norms for acuity on inpatient wards. By reflecting on lessons learned, we re-evaluate the applicability of these oxygenation strategies in the evolving pandemic. We hope to impart to other providers the insights we gained with the challenges of management reasoning in COVID-19.

Keywords: COVID-19; coronavirus; management reasoning; oxygenation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Betacoronavirus / isolation & purification
  • COVID-19
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / virology
  • Disease Management
  • Equipment and Supplies, Hospital / statistics & numerical data
  • Humans
  • Hypoxia / etiology
  • Hypoxia / therapy*
  • Intensive Care Units / statistics & numerical data
  • Male
  • Oxygen Inhalation Therapy / methods*
  • Pandemics
  • Pneumonia / diagnosis
  • Pneumonia / therapy
  • Pneumonia / virology
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / virology
  • Respiratory Insufficiency / etiology*
  • Respiratory Insufficiency / therapy
  • Respiratory Insufficiency / virology
  • SARS-CoV-2
  • United States / epidemiology