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2020, Number 3

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Acta Med 2020; 18 (3)

Mechanical ventilation in patients with COVID-19 according to Gattinoni phenotypes

Ochoa SH, Martínez MI, Díaz GEJ

Language: Spanish
References: 11
Page: 336-340
PDF size: 215.97 Kb.


ABSTRACT

The first cases of a novel virus, called COVID-19, were documented in Wuhan, on December 2019. According to Gattinoni, two different phenotypes can be found in COVID-19-related pneumonia. Both phenotypes show a different Pathophysiology, which can be detected from the moment the patient is admitted to the hospital. 70% of those cases featured Phenotype 1, where pulmonary compliance was higher than 50 mL/cmH2O, while 20% were presented with Phenotype 2 with a pulmonary compliance lower than 50 mL/cmH2O. The use of a CT scan is paramount for early detection and pulmonary compliance measurements must be performed, as soon as the patient is connected to a mechanical ventilator. These procedures allow physicians involved to start treatment and protect the lungs. Among other parameters, a tidal volume of 6 mL/kg and a PEEP of 8-10 mmHg should be used when dealing with Phenotype 1, whereas Phenotype 2 should be treated to certain point as an acute severe respiratory distress syndrome. This article strives to show the sequential algorithm for this methodology, so that these guidelines are available for all treating Physicians that could encounter this type of patients in the future.


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