Mindray 24 Jun 2021
COVID-19 is a disease affecting each one of us in multiple ways and our healthcare system is fighting in this war at the front foot for humankind tirelessly. The constantly evolving COVID-19 variant is forcing clinicians to use an array of different treatment patterns.
Every day new ways are being tested, approved, and being used as the battle against pandemic is reaching its climax. Of all the weapons, the ventilator has proved a game changer. The use of ventilators has become crucial from the moment they were introduced in the battle against the pandemic.
During the first wave of covid it was the impression that a traditional invasive ventilator is a mandatory tool to support patients with severe COVID-19 disease who develop acute respiratory distress syndrome (ARDS) and require respiratory support.
As the disease advanced, more data and analysis came out related to respiratory support devices. And it reflected that NIV (Non Invasive Ventilation) and HFNC may be more useful tools at an early stage of disease.
It is observed that, if NIV is introduced at an earlier stage, it may reduce the chances of intubation required at a later stage. This in turn can avoid associated problems of invasive ventilationn. NIV usage has its own additional advantages in any ICU setup and it becomes a more viable and powerful tool for temporary covid setups working with less staff and limited resources.
In patients with a requirement of high flow of oxygen, traditional O2 therapy demonstrates its limitations. In such cases the usage of HFNC (High Flow Nasal Cannula) or HFOT(High Flow Oxygen Therapy) can play a vital role as it offers high flow of oxygen with oxygen titration facility to avoids further complications such as airway inflammation, increase of airway resistance, and impairment of mucociliary function, probably resulting in impairing secretion clearance. HFNC also decreases energy expenditure, helpful particularly, in the cases of acute respiratory failure.
The primary strategy for COVID-19 patients is supportive care, including oxygen therapy for hypoxemic patients, in which high-flow nasal cannula (HFNC) is more intended to be effective in improving oxygenation and thereafter NIV.
The healthcare system is preparing for the third wave of covid. In such times, as a precaution for children and infants, we can possibly look for advanced respiratory support devices. We need devices that can support from HFNC to NIV and Invasive ventilation and can be more effective at any stage of respiratory support needed.
So, NIV is here to stay as it is more acceptable in the patients.