Schroeder Ines, Irlbeck Michael, Zoller Michael
Klinik für Anästhesiologie, LMU Klinikum, Marchioninistraße 15, 81377, München, Deutschland.
Anaesthesist. 2022 May;71(5):333-339. doi: 10.1007/s00101-022-01114-x. Epub 2022 Apr 9.
The controversy surrounding ventilation in coronavirus disease 2019 (COVID-19) continues. Early in the pandemic it was postulated that the high intensive care unit (ICU) mortality may have been due to too early intubation. As the pandemic progressed recommendations changed and the use of noninvasive respiratory support (NIRS) increased; however, this did not result in a clear reduction in ICU mortality. Furthermore, large studies on optimal ventilation in COVID-19 are lacking. This review article summarizes the pathophysiological basis, the current state of the science and the impact of different treatment modalities on the outcome. Potential factors that could undermine the benefits of noninvasive respiratory support are discussed. The authors attempt to provide guidance in answering the difficult question of when is the right time to intubate?
围绕2019冠状病毒病（COVID-19）通气问题的争议仍在继续。在疫情早期，有人推测重症监护病房（ICU）死亡率高可能是由于过早插管。随着疫情的发展，建议发生了变化，无创呼吸支持（NIRS）的使用增加；然而，这并没有导致ICU死亡率明显降低。此外，缺乏关于COVID-19最佳通气的大型研究。这篇综述文章总结了病理生理基础、科学现状以及不同治疗方式对预后的影响。讨论了可能削弱无创呼吸支持益处的潜在因素。作者试图为回答何时是插管的正确时机这一难题提供指导。
