Department of Critical Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa.
Department of Critical Care and Anaesthesia, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Semin Respir Crit Care Med. 2023 Feb;44(1):91-99. doi: 10.1055/s-0042-1758836. Epub 2023 Jan 16.
This paper discusses mechanisms of hypoxemia and interventions to oxygenate critically ill patients with COVID-19 which range from nasal cannula to noninvasive and mechanical ventilation. Noninvasive ventilation includes continuous positive airway pressure ventilation (CPAP) and high-flow nasal cannula (HFNC) with or without proning. The evidence for each of these modalities is discussed and thereafter, when to transition to mechanical ventilation (MV). Various techniques of MV, again with and without proning, and rescue strategies which would include extra corporeal membrane oxygenation (ECMO) when it is available and permissive hypoxemia where it is not, are discussed.
本文讨论了 COVID-19 危重症患者低氧血症的机制和氧疗干预措施,从鼻导管到无创和机械通气。无创通气包括持续气道正压通气(CPAP)和高流量鼻导管(HFNC),有或无俯卧位。讨论了每种模式的证据,然后讨论了何时转为机械通气(MV)。讨论了各种 MV 技术,同样包括有和无俯卧位,以及当可使用体外膜氧合(ECMO)时的抢救策略,以及在无法使用时的允许性低氧血症。