Noninvasive Ventilation Alone Cannot Solve COVID-19 Respiratory Failure.

Abstract

The respiratory management of severe coronavirus disease (COVID-19) acute hypoxemic respiratory failure has vacillated since the onset of the pandemic. Initially the consensus was to favor early intubation and initiation of invasive mechanical ventilation. Noninvasive ventilation modalities, which include continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BPAP), and humidified high flow oxygen were avoided. This was done to reduce aerosol generation risking infection in others and unrestricted tidal volumes causing injurious transpulmonary pressures.