Basing Respiratory Management of COVID-19 on Physiological Principles

Tobin discusses the need to base respiratory management of COVID-19 on physiological principles. The dominant respiratory feature of coronavirus disease (COVID-19) is arterial hypoxemia greatly exceeding abnormalities in pulmonary mechanics (decreased compliance). Circular thinking is especially dan...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2020-06, Vol.201 (11), p.1319-1320
Main Author: Tobin, Martin J
Format: Article
Language:English
Subjects:
Airway Management - methods
Airway Management - standards
Betacoronavirus
Blood Gas Analysis
Coronavirus Infections - therapy
COVID-19
Disease management
Humans
Hypoxia - diagnosis
Hypoxia - virology
Oximetry
Oxygen
Oxygen Consumption
Pandemics
Patient safety
Pneumonia, Viral - therapy
Respiration, Artificial
Respiratory diseases
SARS-CoV-2
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Summary:Tobin discusses the need to base respiratory management of COVID-19 on physiological principles. The dominant respiratory feature of coronavirus disease (COVID-19) is arterial hypoxemia greatly exceeding abnormalities in pulmonary mechanics (decreased compliance). Circular thinking is especially dangerous when managing patients with coronavirus. After a patient starts on a therapy, it is often stated that the patient is "requiring" the said therapy. Physicians commonly state that "a patient's oxygen requirements are going up" without making any attempt to measure oxygen consumption; it would be more accurate to simply say the patient's level of supplemental oxygen has been increased.
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.202004-1076ED