Важность использования неинвазивной вентиляции легких при новой коронавирусной инфекции (COVID-19)
Abstract
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.
About the Author
С. Авдеев
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)
Russian Federation
Russian Federation
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. National Health Care (Russia). 2020;1(1):33-38. (In Russ.)
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