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首页> 美国卫生研究院文献>Journal of Clinical Medicine >Helmet CPAP to Treat Acute Hypoxemic Respiratory Failure in Patients with COVID-19: A Management Strategy Proposal
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Helmet CPAP to Treat Acute Hypoxemic Respiratory Failure in Patients with COVID-19: A Management Strategy Proposal

机译：头盔CPAP治疗COVID-19患者的急性低氧性呼吸衰竭：管理策略建议

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Since the beginning of March 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused more than 13,000 deaths in Europe, almost 54% of which has occurred in Italy. The Italian healthcare system is experiencing a stressful burden, especially in terms of intensive care assistance. In fact, the main clinical manifestation of COVID-19 patients is represented by an acute hypoxic respiratory failure secondary to bilateral pulmonary infiltrates, that in many cases, results in an acute respiratory distress syndrome and requires an invasive ventilator support. A precocious respiratory support with non-invasive ventilation or high flow oxygen should be avoided to limit the droplets’ air-dispersion and the healthcare workers’ contamination. The application of a continuous positive airway pressure (CPAP) by means of a helmet can represent an effective alternative to recruit diseased alveolar units and improve hypoxemia. It can also limit the room contamination, improve comfort for the patients, and allow for better clinical assistance with long-term tolerability. However, the initiation of a CPAP is not free from pitfalls. It requires a careful titration and monitoring to avoid a delayed intubation. Here, we discuss the rationale and some important considerations about timing, criteria, and monitoring requirements for patients with COVID-19 respiratory failure requiring a CPAP treatment.
机译：自2020年3月开始，2019年冠状病毒病（COVID-19）大流行在欧洲造成13,000多人死亡，其中近54％在意大利发生。意大利的医疗保健系统正承受着沉重的负担，尤其是在重症监护方面。实际上，COVID-19患者的主要临床表现是继发于双侧肺浸润的急性低氧性呼吸衰竭，在许多情况下，这会导致急性呼吸窘迫综合征并需要有创呼吸机支持。应当避免早熟的呼吸支持和无创通气或高流量氧气，以限制飞沫的空气扩散和医护人员的污染。通过头盔施加持续的气道正压通气（CPAP）可以有效地招募患病的肺泡单位并改善低氧血症。它还可以限制房间的污染，提高患者的舒适度，并以长期耐受性提供更好的临床帮助。但是，CPAP的启动并非没有陷阱。它需要仔细的滴定和监测，以避免插管延迟。在这里，我们讨论了需要CPAP治疗的COVID-19呼吸衰竭患者的时机，标准和监测要求的基本原理和一些重要考虑因素。

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