Treatment of Chronic Respiratory Failure in COVID-19 with Acute Respiratory Failure or ARDS
Clinical Scenario
This protocol addresses patients with chronic respiratory failure in the setting of coronavirus disease 2019 (COVID-19) who develop acute respiratory failure (ARF) or acute respiratory distress syndrome (ARDS).
A proportion of patients with COVID-19 develop ARF and ARDS, with risk influenced by patient age, underlying comorbidities, immune status, and SARS-CoV-2 virus genotype, among other factors.
Management Approach (Overview)
Management follows standard ventilatory principles for ARF and ARDS — with ventilation parameters individualized to each patient — alongside pharmacological therapies administered per COVID-19-specific guidance. Additional supportive measures may be considered for select non-intubated patients.
The full regimen, ventilation targets, sequencing, and individualization criteria are in the complete protocol below.
References
DOI: 10.1186/s40560-023-00658-3
- A certain proportion of patients with COVID-19 develop ARF and ARDS depending on patient age, comorbidities, immune status, and SARS-CoV-2 virus genotype among other factors.
- These findings indicate that the management of ARF and ARDS in patients with COVID-19 should be the same as for other causes.
- However, parameters of mechanical ventilation, including PEEP, should be individualized based on the ventilatory and systemic condition of individual patients.
- Pharmacological therapies, including corticosteroids, should be administered according to the guidelines and statements specific to COVID-19.
- In addition to standard ventilatory management, the benefits of awake prone positioning for non-intubated patients have been posited and examined.
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