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  • NONINVASIVE MECHANICAL VENT...
    Pavlisa, Gordana; Gasparovic, Kristina; Puretic, Hrvoje; Ljubicic, Lidija; Nekic, Andrija; Vukovic, Vlasta; Vukancic, Katarina; Dugac, Andrea Vukic

    Acta clinica Croatica (Tisak), 03/2023, Letnik: 62, Številka: S1
    Journal Article

    Coronavirus disease 2019 (COVID-19) is presented with a wide range of symptoms, from asymptomatic disease to severe and progressive interstitial pneumonia. As part of interstitial pneumonia, respiratory failure is typically presented as hypoxia and is the most common cause of hospitalization. When oxygen therapy fails, continuous positive airway pressure (CPAP) or noninvasive mechanical ventilation (NIV) are used as respiratory support measures of first choice. Noninvasive respiratory support (NIRS) is applied in order to save intensive care unit resources and to avoid complications related to invasive mechanical ventilation. Emerging evidence has shown that the use of CPAP or NIV in the management of acute hypoxemic respiratory failure in COVID-19 reduces the need for intubation and mortality. The advantage of NIRS is the feasibility of its application on wards. NIV could be administered via a face mask or helmet interface. Helmet adheres better than mask and therefore leakage is reduced, a delivery of positive end-expiratory pressure is more accurate, and the risk of nosocomial transmission of infections is lowered. Patients on NIRS must be carefully monitored so that further respiratory deterioration is not overlooked and additional measures of care including timely intubation and invasive mechanical ventilation could be performed if needed. Key words: Coronavirus disease 2019; Respiratory failure; Continuous positive airway pressure; Noninvasive mechanical ventilation; Noninvasive respiratory support Bolest uzrokovana novim koronavirusom 2019 (COVID-19) prezentira se sirokim rasponom simptoma, od asimptomatske bolesti do teske i progresivne intersticijske upale pluca. Kao dio intersticijske pneumonije respiracijska insufficijencija tipicno je obiljezena hipoksijom i najcesci je uzrok hospitalizacije. Kada terapija kisikom ne uspije, kontinuirani pozitivni tlak u disnim putovima (CPAP) ili neinvazivna mehanicka ventilacija (NIV) mjere su respiracijske potpore prvog izbora. Neinvazivna respiracijska potpora (NIRS) primjenjuje se kako bi se ustedjeli resursi jedinica intenzivnog lijecenja i izbjegle komplikacije povezane s invazivnom mehanickom ventilacijom. Uporaba CPAP-a ili NIV-a u lijecenju akutne hipoksemicne respiracijske insufficijencije kod COVID-19 smanjuje potrebu za intubacijom i smrtnost. Prednost NIRS-a je da se moze provoditi na odjelima. NIV se moze primijeniti preko maske ili kacige. Kaciga bolje prianja u odnosu na masku i stoga je smanjen gubitak zraka, isporuka pozitivnog tlaka na kraju izdisaja je tocnija, a rizik od nozokomijalnog prijenosa infekcija je manji. Bolesnici na NIRS-u moraju se pazljivo nadzirati kako se ne bi previdjelo daljnje respiracijsko pogorsanje i kako bi se mogle provesti dodatne mjere skrbi ukljucujuci pravodobnu intubaciju i invazivnu mehanicku ventilaciju. Kljucne rijeci: Bolest uzrokovana novim koronavirusom 2019; Respiracijska insufficijencija; Kontinuirani pozitivni tlak u disnim putovima; Neinvazivna mehanicka ventilacija; Neinvazivna respiracijska potpora