Respiratory management in severe acute respiratory syndrome coronavirus 2 infection

Susanna Price; Suveer Singh; Stephane Ledot; Paolo Bianchi; Matthew Hind; Guido Tavazzi; Pascal Vranckx

doi:10.1177/2048872620924613

Respiratory management in severe acute respiratory syndrome coronavirus 2 infection

Eur Heart J Acute Cardiovasc Care. 2020 Apr;9(3):229-238. doi: 10.1177/2048872620924613. Epub 2020 May 7.

Authors

Susanna Price^{1

2}, Suveer Singh^{1

2}, Stephane Ledot^{1

3}, Paolo Bianchi^{1

3}, Matthew Hind⁴, Guido Tavazzi^{5

6}, Pascal Vranckx^{7

8}

Affiliations

¹ Adult Intensive Care, Royal Brompton and Harefield NHS Foundation Trust, UK.
² Imperial College London, UK.
³ Anaesthesia, Royal Brompton and Harefield NHS Foundation Trust, UK.
⁴ Department of Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, UK.
⁵ Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy.
⁶ Anesthesia and Intensive Care, Fondazione Policlinico San Matteo Hospital IRCCS, Italy.
⁷ Department of Cardiology and Intensive Care, Jessaziekenhuis Hasselt, Belgium.
⁸ Faculty of Medicine and Life Sciences, University of Hasselt, Belgium.

Abstract

The severe acute respiratory syndrome coronavirus 2 pandemic is to date affecting more than a million of patients and is challenging healthcare professionals around the world. Coronavirus disease 2019 may present with a wide range of clinical spectrum and severity, including severe interstitial pneumonia with high prevalence of hypoxic respiratory failure requiring intensive care admission. There has been increasing sharing experience regarding the patient's clinical features over the last weeks which has underlined the need for general guidance on treatment strategies. We summarise the evidence existing in the literature of oxygen and positive pressure treatments in patients at different stages of respiratory failure and over the course of the disease, including environment and ethical issues related to the ongoing coronavirus disease 2019 infection.

Keywords: Severe acute respiratory syndrome coronavirus 2; acute respiratory distress syndrome; coronavirus disease 2019; mechanical ventilation; oxygen therapy; respiratory failure.

MeSH terms

Betacoronavirus / isolation & purification*
COVID-19
Civil Defense
Coronavirus Infections / complications*
Coronavirus Infections / epidemiology
Coronavirus Infections / mortality
Coronavirus Infections / virology
Critical Care / methods
Cross Infection / epidemiology
Cross Infection / prevention & control
Disease Management
Extracorporeal Membrane Oxygenation / adverse effects
Extracorporeal Membrane Oxygenation / methods
Female
Humans
Hypoxia / etiology
Hypoxia / therapy*
Ideal Body Weight / physiology
Intubation, Intratracheal / ethics
Intubation, Intratracheal / methods
Male
Oxygen / administration & dosage
Oxygen / therapeutic use
Pandemics
Personal Protective Equipment / standards*
Personal Protective Equipment / supply & distribution
Pneumonia, Viral / complications*
Pneumonia, Viral / epidemiology
Pneumonia, Viral / mortality
Pneumonia, Viral / virology
Positive-Pressure Respiration / methods
Respiration, Artificial / methods
Respiratory Insufficiency / etiology
Respiratory Insufficiency / therapy*
SARS-CoV-2

Substances

Oxygen