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Важность использования неинвазивной вентиляции легких при новой коронавирусной инфекции (COVID-19)

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Аннотация

 На начальных этапах пандемии новой коронавирусной инфекции (COronaVIrus Disease-19, COVID-19) многие руководства по ведению пациентов не содержали  рекомендаций по использованию неинвазивной  вентиляции легких (НВЛ) в связи с опасениями, что НВЛ может сопровождаться высокими дыхательными объемами, способными вызвать повреждение легких, и, кроме того, существовало мнение, что НВЛ повышает риск распространения биоаэрозоля, содержащего вирус SARS-CoV-2. В то же время НВЛ достаточно широко используется в реальной клинической практике при ведении тяжелых пациентов с COVID-19 (в некоторых странах – до 60% среди всех методов респираторной поддержки). Накопленный опыт показывает, что при работе с НВЛ риск контаминации вирусными инфекциями сводится к минимуму при адекватном использовании средств индивидуальной защиты. К настоящему времени доступны результаты небольшого числа исследований, посвященных эффективности НВЛ при гипоксемической острой дыхательной недостаточности (ОДН) у пациентов с COVID-19. В большинстве исследований потребность в интубации трахеи и госпитальная летальность, в среднем, составили 20-30%, что позволяет говорить о достаточно высокой эффективности НВЛ при ОДН у пациентов с COVID-19.  

Об авторе

С. Н. Авдеев
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)
Россия

 д-р мед. наук, профессор, чл.-корр. Российской академии наук, заведующий кафедрой пульмонологии 

ул. Трубецкая, д. 8, стр. 2, г. Москва, 119991, Россия 



Список литературы

1. Zhu N., Zhang D., Wang W., et al. China novel coronavirus investigating and research team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020 Jan 24. N Engl J Med 2020; 382: 727–733.

2. Ruan Q., Yang K., Wang W., et al. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020 May; 46(5): 846-848.

3. Intensive Care National Audit and Research Centre. ICNARC report on COVID-19 in critical care 10 April 2020. ICNARC report on COVID-19 in critical care. 10 April 2020. https://www.icnarc.org

4. Richardson S., Hirsch J.S., Narasimhan M., et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA 2020; 323(20): 2052-2059.

5. Hua J., Qian C., Luo Z., et al. Invasive mechanical ventilation in COVID-19 patient management: the experience with 469 patients in Wuhan. Critical Care 2020; 24: 348.

6. Rochwerg B., Brochard L., Elliott M.W., et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J 2017; 50(2): 1602426.

7. Авдеев С.Н. Неинвазивная вентиляция легких при острой дыхательной недостаточности: от клинических рекомендаций – к реальной клинической практике. Пульмонология 2018; 28(1): 32-35.

8. Faculty of Intensive Care Medicine, Intensive Care Society, Association of Anaesthetists and Royal College of Anaesthetists. Critical care preparation and management in the COVID-19 pandemic – 17 March 2020. https://icmanaesthesiacovid-19.org/critical-care-preparation-and-management-in-the-covid-19-pandemic (accessed 25.03.2020).

9. Alhazzani W., Muller M.H., Arabi Y.M., et al. Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med 2020; 46: 854–887.

10. World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Interim guidance - 13 March 2020. https://apps.who.int/iris/handle/10665/331446 (accessed 25.03.2020).

11. Crimi C., Noto A., Cortegiani A., et al. Noninvasive respiratory support in acute hypoxemic respiratory failure associated with COVID-19 and other viral infections. Minerva Anestesiol 2020; Nov; 86(11): 1190-1204.

12. Attanasi M., Pasini S., Caronni A., et al. Collaborators for the RECOVER investigators study group. Inpatient care during the COVID-19 pandemic: A survey of Italian physicians. Respiration. 2020; 99(8): 667-677.

13. Lai X., Wang M., Qin C., et al. Coronavirus Disease 2019 (COVID-2019) infection among health care workers and implications for prevention measures in a tertiary hospital in Wuhan, China. JAMA Network Open 2020; 3(5): e209666.

14. Tran K., Cimon K., Severn M., et al. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One 2012; 7: e35797.

15. Wu Z., McGoogan J.M. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323 (13): 1239–1242.

16. Niederman M.S., Richeldi L., Chotirmall S.H., Bai C. Rising to the challenge of the novel SARS-coronavirus-2 (SARS-CoV- 2): advice for pulmonary and critical care and an agenda for research. Am J Respir Crit Care Med 2020, 201(9): 1019–1022.

17. Ferioli M., Cisternino C., Leo V., et al. Protecting healthcare workers from SARS-CoV-2 infection: practical indications. Eur Respir Rev 2020; 29: 200068.

18. Lyons C., Callaghan M. The use of high-flow nasal oxygen in COVID-19. Anaesthesia 2020; 75: 843–847.

19. Stetzenbach L.D., Buttner M.P., Cruz P. Detection and enumeration of airborne biocontaminants. Curr Opin Biotechnol 2004; 15: 170–174.

20. Hui D.S., Chan M.T., Chow B.K. Aerosol dispersion during various respiratory therapies: a risk assessment model of nosocomial infection to health care workers. Hong Kong Med J 2014; 20 Suppl 4: 9–13.

21. Hui D.S., Chow B.K., Lo T., et al. Exhaled air dispersion during noninvasive ventilation via helmets and a total facemask. Chest 2015; 147: 1336-1343.

22. Hui D.S., Chow B.K, Lo T., et al. Exhaled air dispersion during high-flow nasal cannula therapy versus CPAP via different masks. Eur Respir J 2019; 53: 53 (4): 1802339.

23. Wang T., Tang C., Chen R., et al. Clinical features of coronavirus disease 2019 patients with mechanical ventilation: A nationwide study in China. Crit Care Med 2020; 48(9): e809-e812.

24. Oranger M., Gonzalez-Bermejo J., Dacosta-Noble P., et al. Continuous positive airway pressure to avoid intubation in SARS-CoV-2 pneumonia: a two-period retrospective case-control study. Eur Respir J. 2020 Aug; 56(2): 2001692.

25. Duca A., Memaj I., Zanardi F., et al. Severity of respiratory failure and outcome of patients needing a ventilatory support in the emergency department during Italian novel coronavirus SARS-CoV-2 outbreak: preliminary data on the role of helmet CPAP and non-invasive ventilation. EClinicalMedicine 2020; 24, 100419.

26. Pagano A., Porta G., Bosso G., et al. Non-invasive CPAP in mild and moderate ARDS secondary to SARS-CoV-2. Respiratory Physiology & Neurobiology 2020; 280: 103489.

27. Nightingale R., Nwosu N., Kutubudin F., et al. Is continuous positive airway pressure (CPAP) a new standard of care for type 1 respiratory failure in COVID-19 patients? A retrospective observational study of a dedicated COVID-19 CPAP service. BMJ Open Resp Res 2020; 7: e000639.

28. Burns G.P., Lane N.D., Tedd H.M., et al. Improved survival following wardbased non-invasive pressure support for severe hypoxia in a cohort of frail patients with COVID-19: retrospective analysis from a UK teaching hospital. BMJ Open Resp Res 2020; 7: e000621.

29. Aliberti S., Radovanovic D., Billi F., et al. Helmet CPAP treatment in patients with COVID-19 pneumonia: a multicenter, cohort study. Eur Respir J 2020 Oct; 56(4): 2001935.

30. Franco C., Facciolongo N., Tonelli R., et al. Feasibility and clinical impact of out-of-ICU non-invasive respiratory support in patients with COVID-19 related pneumonia. Eur Respir J 2020; Nov; 56(5): 2002130.

31. Avdeev S., Yaroshetskiy A., Tsareva N., et al. Noninvasive ventilation for acute hypoxemic respiratory failure in patients with COVID-19. Amer J Emerg Med 2020 Oct 1; S0735-6757(20): 30871-30878.

32. Mukhtar A., Lotfy A., Hasanin A., et al. Outcome of non-invasive ventilation in COVID-19 critically ill patients: A retrospective observational study. Anaesthesia Critical Care & Pain Medicine 2020 Oct; 39(5): 579-580.

33. Gaulton T.G., Bellani G., Foti G., et al. Early clinical experience in using helmet continuous positive airway pressure and high-flow nasal cannula in overweight and obese patients with acute hypoxemic respiratory failure from Coronavirus Disease 2019. Crit Care Explor 2020; 2(9): e0216.

34. Menzella F., Fontana M., Salvarani C., et al. Efficacy of tocilizumab in patients with COVID-19 ARDS undergoing noninvasive ventilation. Critical Care 2020 Sep 29; 24(1): 589.

35. Noeman-Ahmed Y., Gokaraju S., Powrie D.J., et al. Predictors of CPAP outcome in hospitalized COVID-19 patients. Respirology 2020; 25(12): 1316-1319.

36. Vaschetto R., Barone-Adesi F., Racca F., et al. Outcomes of COVID-19 patients treated with continuous positive airway pressure outside ICU. ERJ Open Res 2020 Oct 30: 00541-2020.

37. Antonelli M., Conti G., Moro M.L., et al. Predictors of failure of noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure: a multi-center study. Intensive Care Med 2001; 27: 1718–1728.

38. HFNC and NIV for COVID-19 complicated by respiratory failure. ClinicalTrials.gov identifier: NCT04452708. https://clinicaltrials.gov/ct2/show/NCT04452708 (accessed 10.10.2020).

39. Perkins G.D., Couper K., Connolly B., et al. RECOVERY- Respiratory Support: Respiratory Strategies for patients with suspected or proven COVID-19 respiratory failure; Continuous Positive Airway Pressure, High-flow Nasal Oxygen, and standard care: A structured summary of a study protocol for a randomised controlled trial. Trials 2020; 21: 687.


Для цитирования:


Авдеев С.Н. Важность использования неинвазивной вентиляции легких при новой коронавирусной инфекции (COVID-19). Национальное здравоохранение. 2020;1(1):33-38.

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ISSN 2713-069X (Print)
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