Management of hypoxia in COVID-19: Primum non nocere.

Authors

  • Gentle Sunder Shrestha Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu 44600, Nepal
  • Ankit Rimal Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu 44600, Nepal
  • Pragya Acharya Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu 44600, Nepal

Keywords:

Coronavirus disease, low and middle income countries, Hypoxia

Abstract

Coronavirus disease has exposed the frailty of health systems all over the globe, especially in low and middle-income countries. Continuing research will embolden our knowledge and clarify controversies associated with management of hypoxia in COVID-19.  The aim of this article is to discuss hypoxia in patients with COVID-19, possible modalities for management, including some low-cost and feasible interventions. Surge capacity building and allocation of scarce resources are central to increase capacities to provide patient care while avoiding harm.

Author Biographies

Gentle Sunder Shrestha, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu 44600, Nepal

Intensivist and Anaesthesiologist, Department of Anaesthesiology

Ankit Rimal, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu 44600, Nepal

DM Resident, Critical Care Medicine

Pragya Acharya, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu 44600, Nepal

Anesthesiologist, Department of Anaesthesia

References

 

Zuo M, Huang Y, Ma W, Xue Z, Zhang J, Gong Y, et al. Chinese Society of Anesthesiology Task Force on Airway Management. Expert Recommendations for Tracheal Intubation in Critically Ill Patients with Noval Coronavirus Disease 2019. Chin Med Sci J. 2020;35(2):105-9. https://doi.org/10.24920/003724[PMid:32102726] [PMC Full-text]

Meng L, Qiu H, Wan L, Ai Y, Xue Z, Guo Q, et al. Intubation and Ventilation amid the COVID-19 Outbreak: Wuhan's Experience. Anesthesiology. 2020;132(6):1317-32. https://doi.org/10.1097/ALN.0000000000003296[PMid:32195705] [PMC Full-text]

Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med. 2020;46(6):1099-102. https://doi.org/10.1007/s00134-020-06033-2 [PMid:32291463] [PMC Full-text]

Berlin DA, Gulick RM, Martinez FJ. Severe Covid-19. N Engl J Med. 2020 May 15;doi: 10.1056/NEJMcp2009575. https://doi.org/10.1056/NEJMcp2009575[PMid:32412710]

Ferreyro BL, Angriman F, Munshi L, Del Sorbo L, Ferguson ND, Rochwerg B, et al. Association of Noninvasive Oxygenation Strategies With All-Cause Mortality in Adults With Acute Hypoxemic Respiratory Failure: A Systematic Review and Meta-analysis. JAMA. 2020;324(1):1-12. https://doi.org/10.1001/jama.2020.9524 [PMid:32496521]

Interim guidance on clinical management of COVID-19 [Internet]. WHO; 2020. Available from: https://www.who.int/publications/i/item/clinical-management-of-covid-19. Accessed on July 22, 2020.

Ding L, Wang L, Ma W, He H. Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS: a multi-center prospective cohort study. Crit Care. 2020;24(1):28. https://doi.org/10.1186/s13054-020-2738-5[PMid:32000806] [PMC Full-text]

Koeckerling D, Barker J, Mudalige NL, Oyefeso O, Pan D, Pareek M, et al. Awake prone positioning in COVID-19. Thorax. 2020 Jun 16;thoraxjnl-2020-215133.  doi: 10.1136/thoraxjnl-2020-215133. https://doi.org/10.1136/thoraxjnl-2020-215133 [PMid:32546571]

Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L, et al. Dexamethasone in Hospitalized Patients with Covid-19 - Preliminary Report. N Engl J Med. 2020 Jul 17. doi: 10.1056/NEJMoa2021436. https://doi.org/10.1056/NEJMoa2021436 [PMid:32678530] [PMCFull-text]

Paneru HR. Intensive care units in the context of COVID-19 in Nepal: current status and need of the hour. Journal of Society of Anesthesiologists of Nepal. 2020;7(1):e291. [Full-text]

Downloads

Published

2020-08-22

How to Cite

Shrestha, G. S., Rimal, A., & Acharya, P. (2020). Management of hypoxia in COVID-19: Primum non nocere. Journal of Society of Anesthesiologists of Nepal, 7(1), e305. Retrieved from http://www.jsan.org.np/jsan/index.php/jsan/article/view/305

Most read articles by the same author(s)