Non-invasive respiratory support paths in hospitalized patients with COVID-19: proposal of an algorithm

Pulmonology. 2021 Jul-Aug;27(4):305-312. doi: 10.1016/j.pulmoe.2020.12.005. Epub 2021 Jan 20.

Abstract

COVID-19 related Acute Respiratory Failure, may be successfully treated with Conventional Oxygen therapy, High Flow Nasal Cannula, Continuous Positive Airway Pressure or Bi-level Positive-Pressure ventilation. Despite the accumulated data in favor of the use of different Non-invasive Respiratory therapies in COVID-19 related Acute Respiratory Failure, it is not fully understood when start, escalate and de-escalate the best respiratory supportive option for the different timing of the disease. Based on the current published experience with Non-invasive Respiratory therapies in COVID-19 related Acute Respiratory Failure, we propose an algorithm in deciding when to start, when to stop and when to wean different NIRT. This strategy may help clinicians in better choosing NIRT during this second COVID-19 wave and beyond.

Keywords: Awake proning; Bilevel-PAP; COVID-19; CPAP; High-flow nasal cannula.

MeSH terms

  • Algorithms
  • Blood Gas Analysis
  • COVID-19 / therapy*
  • Cannula
  • Continuous Positive Airway Pressure / methods*
  • Humans
  • Hypoxia / therapy*
  • Intubation, Intratracheal
  • Noninvasive Ventilation / methods*
  • Oxygen Inhalation Therapy / methods*
  • Patient Positioning
  • Positive-Pressure Respiration / methods
  • Prone Position
  • Respiration, Artificial
  • Respiratory Insufficiency / therapy*
  • Respiratory Rate
  • SARS-CoV-2