TY - JOUR
T1 - Timing of Intubation in COVID-19
T2 - When It Is Too Early and When It Is Too Late
AU - Grotberg, John C.
AU - Kraft, Bryan D.
N1 - Publisher Copyright:
© Copyright 2023 The Authors. Published by Wolters Kluwer Health, Inc.
PY - 2023/2/13
Y1 - 2023/2/13
N2 - The timing of initiating mechanical ventilation in patients with acute respiratory distress syndrome due to COVID-19 remains controversial. At the outset of the pandemic, "very early"intubation was recommended in patients requiring oxygen flows above 6 L per minute but was followed closely thereafter by avoidance of invasive mechanical ventilation (IMV) due to a perceived (yet over-estimated) risk of mortality after intubation. While the use of noninvasive methods of oxygen delivery, such as high-flow nasal oxygen (HFNO) or noninvasive positive pressure ventilation (NIV), can avert the need for mechanical ventilation in some, accumulating evidence suggests delayed intubation is also associated with an increased mortality in a subset of COVID-19 patients. Close monitoring is necessary in COVID-19 patients on HFNO or NIV to identify signs of noninvasive failure and ensure appropriate provision of IMV.
AB - The timing of initiating mechanical ventilation in patients with acute respiratory distress syndrome due to COVID-19 remains controversial. At the outset of the pandemic, "very early"intubation was recommended in patients requiring oxygen flows above 6 L per minute but was followed closely thereafter by avoidance of invasive mechanical ventilation (IMV) due to a perceived (yet over-estimated) risk of mortality after intubation. While the use of noninvasive methods of oxygen delivery, such as high-flow nasal oxygen (HFNO) or noninvasive positive pressure ventilation (NIV), can avert the need for mechanical ventilation in some, accumulating evidence suggests delayed intubation is also associated with an increased mortality in a subset of COVID-19 patients. Close monitoring is necessary in COVID-19 patients on HFNO or NIV to identify signs of noninvasive failure and ensure appropriate provision of IMV.
KW - COVID-19
KW - artificial respiration
KW - intubation
KW - noninvasive ventilation
KW - respiratory distress syndrome
UR - http://www.scopus.com/inward/record.url?scp=85148211998&partnerID=8YFLogxK
U2 - 10.1097/CCE.0000000000000863
DO - 10.1097/CCE.0000000000000863
M3 - Review article
C2 - 36817964
AN - SCOPUS:85148211998
SN - 2639-8028
VL - 5
SP - E0863
JO - Critical Care Explorations
JF - Critical Care Explorations
IS - 2
ER -