Respiratory support in patients with COVID-19 (outside intensive care unit). A position paper of the Respiratory Support and Chronic Care Group of the French Society of Respiratory Diseases

Respir Med Res. 2020 Nov:78:100768. doi: 10.1016/j.resmer.2020.100768. Epub 2020 May 27.

Abstract

With first cases noted towards the end of 2019 in China, COVID-19 infection was rapidly become a devastating pandemic. Even if most patients present with a mild to moderate form of the disease, the estimated prevalence of COVID-19-related severe acute respiratory failure (ARF) is 15-20% and 2-12% needed intubation and mechanical ventilation. In addition to mechanical ventilation some other techniques of respiratory support could be used in some forms of COVID-19 related ARF. This position paper of the Respiratory Support and Chronic Care Group of the French Society of Respiratory Diseases is intended to help respiratory clinicians involved in care of COVID-19 pandemic in the rational use of non-invasive techniques such as oxygen therapy, CPAP, non-invasive ventilation and high flow oxygen therapy in managing patients outside intensive care unit (ICU). The aims are: (1) to focus both on the place of each technique and in describing practical tips (types of devices and circuit assemblies) aimed to limit the risk of caregivers when using those techniques at high risk spreading of viral particles; (2) to propose a step-by-step strategy to manage ARF outside ICU.

Keywords: Acute respiratory failure; COVID-19; High flow oxygen therapy; Non invasive ventilation; Oxygen.

Publication types

  • Practice Guideline

MeSH terms

  • Acute Disease
  • COVID-19 / complications
  • COVID-19 / epidemiology*
  • COVID-19 / pathology
  • COVID-19 / therapy*
  • Chronic Disease
  • Continuous Positive Airway Pressure / methods
  • Continuous Positive Airway Pressure / standards
  • Critical Care / methods
  • Critical Care / standards
  • Emergency Medical Services / methods
  • Emergency Medical Services / standards*
  • France / epidemiology
  • Humans
  • Intensive Care Units / standards
  • Nebulizers and Vaporizers / standards
  • Oxygen Inhalation Therapy / methods
  • Oxygen Inhalation Therapy / standards*
  • Pandemics
  • Pulmonary Medicine / methods
  • Pulmonary Medicine / organization & administration
  • Pulmonary Medicine / standards*
  • Respiration Disorders / epidemiology
  • Respiration Disorders / etiology
  • Respiration Disorders / pathology
  • Respiration Disorders / therapy*
  • Respiration, Artificial / methods
  • Respiration, Artificial / standards
  • Respiratory Distress Syndrome / epidemiology
  • Respiratory Distress Syndrome / etiology
  • Respiratory Distress Syndrome / pathology
  • Respiratory Distress Syndrome / therapy
  • Severity of Illness Index
  • Societies, Medical / standards