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COVID-19 – Respiratory Failure and ICU Care Treatment

March 15, 2021
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Specifically for COVID-19 patients, what is the most common reason for ICU level of care? COVID-19 is an infectious disease, primarily affecting the lungs, and therefore respiratory failure is the most common reason COVID-19 patients require ICU level care. Patients with respiratory failure will require supplemental oxygen, which can be delivered through different mechanisms. COVID-19 patients on a general hospital floor usually only require nasal cannular oxygen therapy. When nasal cannular oxygen support is insufficient, high flow oxygen, noninvasive positive pressure ventilation, or mechanical ventilation become necessary, prompting transfer of a patient to the ICU. Mechanical ventilation involves connecting a patient's respiratory system to a ventilator machine through an endotracheal tube. The ventilator machine provides all of the respiratory support a patient needs, buying time for the patient's lungs to heal. It's important to realize that the ventilator machine actually does nothing to treat the underlying disease or cause of respiratory failure. In other words, the ventilator itself isn't treating the COVID-19 infection itself. The ventilator simply provides the respiratory support to buy time for patients to recover. While receiving respiratory support through mechanical ventilation, patients are administered medications, such as remdesivir and steroids to treat the COVID-19 infection and decrease inflammation in the lungs. These therapies allow the lung to heal and recover. As the lung function improves, patients can then be weaned off of needing ventilator support.

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