Noninvasive ventilation: How can we use it during Covid

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As the coronavirus disease (COVID-19) continues to spread, we have made this a top priority for all of us at Philips. Our global resources have been mobilized to continue to fulfill the critical and increased customer needs of healthcare providers and the patients they are taking care of while ensuring the health and safety of our employees and ensuring business continuity.  Employees around the world are stepping up to support healthcare providers and their patients with our broad portfolio of products, services, and solutions that can help address the preparedness, response, and recovery needs of an infectious respiratory disease such as COVID-19.

healthcare workers must not only determine the best course of treatment but also ensure that the virus is not being spread. There is a range of clinical solutions available for managing patients in respiratory failure, and one way we are supporting providers during this crisis is by trying to optimize the non-invasive ventilation (NIV) therapy. We have outlined some recommendations below, in the hope that these could be of help for anyone treating COVID-19 patients. These recommendations are not meant to replace existing World Health Organization (WHO), national guidelines, or established hospital protocols, and of course, decisions regarding any specific treatment must be made by the healthcare provider and the patient based on specific clinical conditions and available resources.

Key Considerations When Using NIV Therapy for COVID-19 Patients

Non-invasive ventilation (NIV) therapy provides both oxygenation and ventilation support and can enable providers to tailor ventilation pressures and flows to match the patient’s breathing patterns. For healthcare providers considering NIV therapy for their COVID-19 patients, it is important to follow the general principles for managing acute hypoxemic respiratory failure when using this therapy. While NIV won’t be an option for every patient with COVID-19 depending on the severity of their symptoms, it has the potential to help many patients in respiratory distress, while ensuring that invasive ventilation options are available for the critically ill. 

Just as important, COVID-19 is extremely contagious and is being transmitted quickly. It’s vitally important to adhere to infection control measures as outlined by hospital or health department policies to avoid transmission of COVID-19 during therapy. Recommendations from the WHO and the Centers for Disease Control and Prevention (CDC) include using negative pressure isolation rooms for patients, and gloves, gowns, and masks for caregivers.

Adapting Care & Precautions for Different Therapies

Understanding which ventilation technique is appropriate for each patient can help improve patient care and assist clinical teams in success. There are different ways to support COVID-19 patients with NIV therapy and depend one on the route of the best course of treatment, each comes with different considerations. 

Continuous Positive Airway Pressure (CPAP) or Bilevel Positive Airway Pressure (BiPAP): If CPAP or BiPAP is considered appropriate in patients with mild hypoxemia and hypercarbia – such as patients with exacerbation of chronic obstructive pulmonary disease (COPD). 

This was the use of noninvasive ventilation during covid. 

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