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2020, Number 6

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Med Crit 2020; 34 (6)

Alveolar protection measures in patients with COVID-19

García SY, Cruz MB, Ortiz LF, Torres AJD

Language: Spanish
References: 30
Page: 341-348
PDF size: 265.33 Kb.


ABSTRACT

COVID-19, the disease spectrum caused by the new beta coronavirus SARS-CoV-2 was declared as a pandemic by the WHO in March 2020. Until November 2020 more than 995,000 cases and nearly 100,000 deaths had been confirmed have been confirmed in Mexico, being one of the 10 countries with the highest index of cases. Most patients have a mild disease not requiring hospitalization, but severe cases with respiratory failure may require mechanical ventilation with a high mortality rate up to 73.7% in some series in Mexico. Mechanical ventilation saves lives but, it is not out of risk as it may cause harm through many mechanisms named VILI on the whole (ventilator-induced lung injury). After more than 50 years since its first description, protective mechanical ventilation has become the standard of care in ARDS patients, but this pandemic has opened the gap for new research. Protective mechanical ventilation: low tidal volumes 6-8 mL/kg predicted body weight (PBW) and plateau pressure < 30 cmH2O has improved patients' outcomes in the last 20 years. Even though COVID-19 has certain differences with the "classical" ARDS, evidence-based medicine suggests the same strategies should be followed.


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