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Noninvasive Ventilatory Support in COVID-19: Friend or Foe?

Objective- To communicate interim guidelines for noninvasive ventilatory support in COVID-19 pandemic.

With intensive care units (ICUs) overwhelmed during the current coronavirus disease of 2019 (COVID-19) pandemic, many hospitals have turned to noninvasive ventilation (NIV) to stave off severe respiratory failure and ease the pressure on limited resources.

  1. For continuous positive airway pressure (CPAP) and high-flow nasal cannula (HFNC) to slow disease progression, the hospital should use CPAP, bilevel positive airway pressure (BiPAP) and NIV devices for treatment.
  2. European Society of Intensive Care Medicine (ESICM) advises the use of oxygen delivered by HFNC as first-line therapy for patients with COVID-19 and for acute hypoxemic respiratory failure in preference to noninvasive positive-pressure ventilation (NIPPV)/CPAP. The CPAP could be used with close monitoring and short-interval assessment for worsening respiratory failure.
  3. CPAP is extremely beneficial for reducing ICU admissions
  4. CPAP also reduces the number of patients requiring intubation because nurses can administer it.

References: Noninvasive Ventilatory Support in COVID-19: Friend or Foe? Available from: https://www.medscape.com/viewarticle/928259. Accessed on May 7, 2020.