COVID-19 Severe Acute Respiratory tract infection and Pneumonia: Recommendations for Oxygen Therapy

What is it about?

COVID-19 Severe Acute Respiratory tract infection and Pneumonia: Recommendations for Oxygen Therapy

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Why is it important?

This article reviews the WHO and CDC guidelines of oxygen therapy for COVID-19 infected patients keeping in view the resource limited constraints of a healthcare system. Early recognition of patients with worsening respiratory function while on conventional oxygen therapies, such as simple face masks or masks with reservoir bags and referral to a tertiary care center for advanced oxygen therapy and mechanical ventilation is important to ensure the timely and safe escalation of respiratory support. Early optimisation of care and involvement of medical care Unit is suggested. In patients with COVID-19 there is the potential for a worsening of hypoxemia and an increased need for high flow oxygen and intensive care management so close monitoring is advised. The resource limitations are oxygen supply or availability of oxygen delivery devices, personal protective equipment for the staff, proper donning and doffing areas dedicated for suspected and confirmed covid positive patients. The idea of writing this review article was to ensure safe and economical management of these patients in a resource constrained setting using minimum possible measures. In the mild and moderate stages of disease, normal oxygen supportive measures (facemask oxygen) could also be advantageous. Supplemental oxygen therapy is immediately needed for patients with respiratory distress, hypoxemia or shock with a target SpO2 >94% as recommended by the WHO. Patients may still have increased work of breathing or hypoxemia even when oxygen is delivered via a mask with reservoir bag (flow rates of 10–15 L/min, which is usually the minimum flow required to take care of bag inflation; FiO2 0.60–0.95).

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