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Non-invasive ventilation for acute hypoxemic respiratory failure,including COVID-19

Journal of Intensive Medicine 2023年第1期3卷 11-19页

作者： Tommaso Rosà luca salvatore menga Ambika Tejpal Melania Cesarano Teresa Michi Michael C.Sklar Domenico luca Grieco Department of Emergency Intensive Care Medicine and AnesthesiaFondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy Istituto di Anestesiologiae Rianimazione UniversitàCattolica del Sacro CuoreRome 00168Italy Division of Cardiology Department of MedicineUniversity of TorontoToronto ON M5S 1A1Canada Interdepartmental Division of Critical Care Medicine University of TorontoToronto ON M5S 1A1Canada Department of Anesthesia and Pain Medicine St.Michael's Hospital–Unity Health TorontoUniversity of TorontoToronto ON M5S 1A1Canada

Optimal initial non-invasive management of acute hypoxemic respiratory failure(AHRF),of both coronavirus disease 2019(COVID-19)and non-COVID-19 etiologies,has been the subject of significant *** of endotracheal intubation reduces related complications,but maintenance of spontaneous breathing with intense respiratory effort may increase risks of patients’self-inflicted lung injury,leading to delayed intubation and worse clinical ***-flow nasal oxygen is currently recommended as the optimal strategy for AHRF management for its simplicity and beneficial physiological ***-invasive ventilation(NIV),delivered as either pressure support or continuous positive airway pressure via interfaces like face masks and helmets,can improve oxygenation and may be associated with reduced endotracheal intubation ***,treatment failure is common and associated with poor *** and knowledge of the specific features of each interface are necessary to fully exploit their potential benefits and minimize *** clinical and physiological monitoring is necessary during any treatment to avoid delays in endotracheal intubation and protective *** this narrative review,we analyze the physiological benefits and risks of spontaneous breathing in AHRF,and the characteristics of tools for delivering *** goal herein is to provide a contemporary,evidence-based overview of this highly relevant topic.

关键词： Non-invasive ventilation Hypoxemic respiratory failure Self-inflicted lung injury

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