Abstract - Journal of Trauma and Critical Care (2020) Volume 5, Issue 3
Potential of lung recruitability and PEEP titration in sever ARDS and SARS-Cov-2: A bedside approach for Open-lung Strategy.
Managing SARS-Cov-2 associated with Acute Respiratory Distress Syndrome (ARDS) in mechanically ventilated patients with refractory hypoxemia and PaO2/FiO2 ratio < 100 can be challenging in Intensive Care Units (ICUs). Optimizing ventilator settings through a lung protective strategy while maintaining adequate oxygenation and ventilation is a worldwide obstacle nowadays. A very effective approach is the open lung strategy (low tidal volume (Vte), low plateau pressure, low driving pressure, recruitment maneuver (RM) and PEEP titration); this approach is effective as long as it is selected for patients with a high potential of lung recruit ability. Studies have shown that those patients have a high mortality rate. However, performing an effective recruitment on them followed by PEEP titration can lead to improved physiological outcomes as well as primary outcomes. Therefore, it is necessary for health care practitioners to be familiar with the bedside assessment for lungs’ potential of recruit ability in order to use this approach with the right group of population (H-phenotype covid-19 with a high potential of lung recruit ability).Author(s): Aqeel J. Almayouf