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Airway Management During Mechanical Ventilation: COVID-19

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Personalized Mechanical Ventilation

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Abstract

The disease caused by the new SARS-CoV-2 can elicit a violent, dysregulated host immune response that can lead to severe results in most of these older patients as ARDS, multiple-organ failure, and death. Acute respiratory distress syndrome (ARDS) is defined as hypoxemia secondary to a rapid onset of non-cardiogenic pulmonary edema. The airway management in a patient with COVID-19 should be carried out considering several aspects. Once it is decided to intubate the patient, use a rapid induction sequence. When signs of respiratory distress are associated with severe hypoxemia, patients should be managed as soon as possible according to the pulmonary phenotypes; however, management of mechanical ventilation must be personalized; if possible, use low tidal volume with 6 mL/kg of predicted body weight. There is no consensus regarding the best PEEP value; several guidelines recommended keeping Pplat 30 cmH2O in patients with ARDS. There are no available studies that describe the clinical evolution of COVID-19 patients ventilated in the prone position; intermittent doses of neuromuscular blocking agents to facilitate lung-protective ventilation, and tracheostomy, remain necessary in some patients with COVID-19.

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Author information

Authors and Affiliations

  1. IESS Quevedo General Hospital, Quevedo, Ecuador

    Carlos Sánchez

  2. Critical Care Division, Belize Healthcare Partners, Belize, Belize

    Jorge Hidalgo

  3. Biochemistry, Arizona State University, Phoenix, AZ, USA

    Allyson Hidalgo

  4. Faculty of Medicine, University of Panama, Panama City, Panama

    Jorge E. Sinclair De Frías

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  1. Carlos Sánchez
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  2. Jorge Hidalgo
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  3. Allyson Hidalgo
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  4. Jorge E. Sinclair De Frías
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Editor information

Editors and Affiliations

  1. Critical Care Division Belize Healthcare Partners, Belize, Belize

    Jorge Hidalgo

  2. Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Robert C Hyzy

  3. Critical Care Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates

    Ahmed Mohamed Reda Taha

  4. Critical Care, King Faisal Specialist Hospital & Research, Riyadh, Saudi Arabia

    Yasser Younis A. Tolba

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Sánchez, C., Hidalgo, J., Hidalgo, A., Sinclair De Frías, J.E. (2022). Airway Management During Mechanical Ventilation: COVID-19. In: Hidalgo, J., Hyzy, R.C., Mohamed Reda Taha, A., Tolba, Y.Y.A. (eds) Personalized Mechanical Ventilation . Springer, Cham. https://doi.org/10.1007/978-3-031-14138-6_4

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  • DOI: https://doi.org/10.1007/978-3-031-14138-6_4

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