By Dr. Viswesvaran Balasubramanian
The Coronavirus pandemic (COVID-19) presents many challenges for the analysis neighborhood and healthcare program worldwide. Around 10 to 20 % of hospitalized patients with infected COVID-19 may well endure from serious pneumonia and Acute Respiratory Distress Syndrome (ARDS), requiring assistance with mechanical ventilation. Though ARDS can be brought on by different direct or indirect pulmonary insults such as other respiratory infections, trauma, aspiration or inhalation injuries to lung, the serious hypoxemic respiratory failure secondary to COVID-19 infection has resulted in an unprecedented quantity of patients admitted to intensive care units (ICUs) worldwide. With ongoing pandemic, healthcare researchers and clinicians worldwide are striving to comprehend the prospective exclusive features of illness.
Evolving scientific details recommend that ARDS connected to serious COVID-19 alo referred to as CARDS may well differ from common ARDS. Studies have observed that CARDS may well present as the classical ARDS pattern exactly where these with the lowest oxygenation level also have the worst lung mechanics and the smaller sized aerated lung. However, exclusive to CARDS is that handful of patients may well present with poor oxygenation status regardless of possessing fantastic lung mechanics suggesting various illness processes.
Many patients with CARDS have a fairly fantastic tolerance of low blood oxygen referred to as silent hypoxaemia which is also referred to as “happy hypoxaemia”. This dissociation among oxygenation and work of breathing in some of these patients has an effect on selection producing of supporting a patient with mechanical ventilation and has prompted some clinicians to keep away from mechanical ventilators till clinical indicators of clinical deterioration happen. In addition to this, other modalities of enhancing oxygenation such as awake self-proning and use of higher-flow nasal cannula and ECMO has gained significance through the existing pandemic. In addition to this handful of research have observed that significantly less use of invasive ventilation was linked with a reduce mortality in clinical trials. With respect to drugs, the use of corticosteroids in COVID-19 patients requiring supplemental oxygen or ventilatory assistance has resulted in enhanced outcomes. Similarly, in choose patients the use of IL-6 receptor antagonist monoclonal antibody therapy to hospitalised patients with COVID-19 requiring oxygen or ventilatory assistance is recommended. Most remedy suggestions also propose the use of anticoagulation for all hospitalised patients with COVID-19. With evolving information and analysis, we may well see newer modality emerging which may well have an effect on the clinical outcomes of patients suffering with CARDS.
(The author is Consultant Interventional Pulmonology and Sleep Medicine, Yashoda Hospitals Hyderabad. The short article is for informational purposes only. Please seek the advice of overall health authorities and healthcare pros prior to beginning any therapy or medication. Views expressed are individual and do not reflect the official position or policy of the TheSpuzz Online.)