PATHOPHYSIOLOGY-BASED RESPIRATORY THERAPY OF PNEUMONIA CAUSED BY SARS-CoV-2
About 5% of patients with COVID-19 are in critical condition. Most of them need hardware support or complete replacement of lung function.
The aim of this article is to review the current WHO interim guideline and other literature sources on respiratory support for patients with COVID-19. Elucidation of the features of pathophysiology-based approach to the choice of parameters of respiratory therapy of pneumonia caused by SARS-CoV-2.
Materials and methods. The materials of the study were the recommendations of world-renowned organizations involved in the fight against the COVID-19 pandemic, as well as materials of publications that summarize the international experience in the treatment of viral pneumonia. Research methods – bibliosemantic, analytical.
Results. The article discusses the controversial issues of respiratory support of patients with COVID-19. An alternative view of Italian researchers on the existence of fundamentally different phenotypes of pneumonia caused by SARS-CoV-2 is given. Pathophysiological changes in the respiratory system, which determine the presence of different phenotypes of pneumonia in COVID-19, are substantiated. Particular attention is paid to the differentiated selection of parameters of respiratory therapy of pneumonia caused by SARS-CoV-2, according to the phenotype of this pathology.
Conclusions. Highlight the main aspects of the pathophysiology-based approach to respiratory therapy of pneumonia caused by SARS-CoV-2. Practical recommendations for the selection of individual parameters of artificial lung ventilation in patients with COVID-19 are formulated.
Key words: COVID-19, SARS-CoV-2 pneumonia, pneumonia phenotype, patient-induced lung injury, respiratory therapy, positive end-expiratory pressure.
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