Abstract
In 2019, a pandemic began due to infection with a novel coronavirus, SARS-CoV-2. In many cases, this coronavirus leads to the development of the COVID-19 disease. Lung damage in the course of this disease often leads to acute hypoxic respiratory failure and may eventually lead to acute respiratory distress syndrome (ARDS). Respiratory failure as a result of COVID-19 can develop very quickly and a small percent of those infected will die because of it. There is currently no treatment for COVID-19, therefore the key therapeutic intervention centers around the symptomatic treatment of respiratory failure. The main therapeutic goal is to main-tain gas exchange, mainly oxygenation, at an appropriate level and prevent the intensification of changes in the lung parenchyma. Depending on the severity of hypoxemia different techniques can be used to improve oxygenation. Medical staff dealing with COVID-19 patients should be familiar with both, methods used to treat respiratory failure and the epidemiological risks arising from their use. In some patients, conventional (passive) oxygen therapy alone is sufficient. In patients with worsening respiratory failure high flow nasal oxygen therapy (HFNOT) may be effective. The continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) methods can be used to a limited extent. With further disease progression, invasive ventilation must be used and in special situations, extracorporeal membrane oxygenation (ECMO) can also be administered. The authors of this article set themselves the goal of presenting the most current knowledge about the epidemiology and patho-physiology of respiratory failure in COVID-19, as well as the methods of its treatment. Given the dynamics of the developing pandemic, this is not an easy task as new scientific data is presented almost every day. However, we believe the knowledge contained in this study will help doctors care for patients with COVID-19. The main target audience of this study is not so much pneumonologists or intensivists who have extensive experience in the application of the techniques discussed here, but rather doctors of other specializations who must master new skills in order to help patients during the time of a pandemic.
Highlights
The pandemic caused by the SARS-CoV-2 virus has, suddenly and unexpectedly, caused health services to be faced with previously unknown and difficult challenges
The randomized study assessing the effectiveness of high flow nasal oxygen therapy (HFNOT) in the treatment of hypoxic respiratory failure showed a reduction in mortality in patients treated with HFNOT (PaO2/FiO2 < 300 mm Hg) compared to groups treated with conventional oxygen therapy or non-invasive mechanical ventilation (NIV) [27]
The COVID-19 disease is mild in approx. 80% of cases, but other patients require hospitalization and a large proportion of them develop viral pneumonia
Summary
The pandemic caused by the SARS-CoV-2 virus has, suddenly and unexpectedly, caused health services to be faced with previously unknown and difficult challenges. On the contrary, depending on the patient’s initial state, severity of hypoxemia, respiratory effort, available equipment, possibility of patient isolation, and the possibility of implementing invasive ventilation, one should start with a treatment method that will ensure satisfactory oxygenation of blood while taking the safety of the staff into account. The randomized study assessing the effectiveness of HFNOT in the treatment of hypoxic respiratory failure showed a reduction in mortality in patients treated with HFNOT (PaO2/FiO2 < 300 mm Hg) compared to groups treated with conventional oxygen therapy (non-rebreather mask) or NIV [27].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
