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Oxygen Therapy in COVID-19

Year 2021, Issue: 14, 376 - 388, 31.08.2021

Emel Yıldız Sevil Alkan Murat Emre Tokur Canan Balcı

https://doi.org/10.38079/igusabder.838044

Abstract

The clinical course of our global problem, coronavirus-associated disease 2019 (COVID-19), is variable. Older age, hypertension, diabetes, chronic lung disease, asthma, chronic kidney diseases, liver diseases, cancer, obesity and smoking are risk factors. Approximately 15% of patients with COVID-19 develop moderate to severe illness and require hospitalization and O2 support; 5% may need an intensive care (ICU). Approximately 15% of patients with COVID-19 develop moderate to severe disease and require hospitalization and O2 support; 5% may need in intensive care units (ICUs). Acute O2 therapy is indicated in cases of arterial hypoxemia (arterial oxygen saturation (SpO2) <90%, Pa O2<60 mmHg), tissue hypoxia, hypotension, metabolic acidosis and respiratory distress. COVID-19 patients have persistent hypoxia. In resistant hypoxia patients, it is defined as SpO2 levels that are incompatible with life without shortness of breath. This may increase the desire of patients to be followed in ICU. However, in order to use ICU effectively and effectively, it is a more correct approach to recruit a patient with a diagnosis of COVID-19 with the correct indication and to follow-up the patients who can be followed in the services. Pulse oximetry and SpO2 monitoring of COVID-19 patients, especially the risky group, is important. Patients are diagnosed before they give symptoms and O2 treatment is initiated.

Keywords

oxygen covid-19 hypoxemia

References

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  • T.C. Sağlık Bakanlığı Bilimsel Danışma Kurulu Çalışması. COVID-19 (Sars-CoV-2 enfeksiyonu) Ağır Pnömoni, ARDS, Sepsis ve Septik Şok Yönetimi. T.C. Sağlık Bakanlığı. https://covid19.saglik.gov.tr/Eklenti/39297/0/covid-19rehberiagirpnomoniardssepsisveseptiksokyontemipdf.pdf. Yayınlanma tarihi 23 Ekim 2020.
  • Morrison M, Weingart S. What if I Get Called In...COVID Airway Management for the Non-Intensivist. Hippo Education. https://www.hippoed.com/pc/rap/episode/whatifiget/whatifiget. Yayınlanma tarihi 20 Nisan 2020. Erişim tarihi 11 Kasım 2020.
  • Liu W, Li H. COVID-19:Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism. ChemRxiv. https://chemrxiv.org/engage/chemrxiv/article-details/60c74fa50f50db305139743d. Yayınlanma tarihi 2020. https://doi.org/10.26434/chemrxiv.11938173.v9
  • Tobin MJ, Langhi F, Jubran A.Why Covid-19 silent hypoxemia is baffling to physicians. Am J Respir Crit Care Med. 2020;202(3):356–360.
  • Dhont S, Derom E, Braeckel EV, Depuydt P, Lambrecht BN. The pathophysiology of ‘happy’ hypoxemia in COVID-19. Respiratory Research. 2020;(21):198.
  • Peterson DD, Pack AI, Silage DA, Fishman AP. Effects of aging on ventilatory and occlusion pressure responses to hypoxia and hypercapnia. Am Rev Respir Dis. 1981;(124):387–391.
  • Goyal D, Donnelly H, Kussner A, et al. Oxygen and mortality in COVID-19 pneumonia: a comparative analysis of supplemental oxygen policies and health outcomes across 26 countries. Medrxiv. 2020:1-17.
  • Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of Coronavirus Disease 2019 in China. N Engl J Med.2020;(382):1708-1720.
  • Sardesai I, Grover J, Garg M, et al. Short term home oxygen therapy for COVID-19 patients: the COVID-HOT algorithm. J Family Med Prim Care. 2020; 9(7): 3209–3219.
  • Barrot L, Asfar P, Mauny F, et al. Liberal or conservative oxygen therapy for acute respiratory distress syndrome. N Engl J Med. 2020;382(11):999-1008.
  • Alhazzani W, Morten HM, Arabi YM, et al. Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med. 2020;46(5):854-887.
  • Ni YN, Luo J, Yu H, et al. The effect of high-flow nasal cannula in reducing the mortality and the rate of endotracheal intubation when used before mechanical ventilation compared with conventional oxygen therapy and noninvasive positive pressure ventilation. A systematic review and meta-analysis. Am J EmergMed. 2018;36(2):226-233.
  • Archer SL, Sharp WW, Weir EK. Differentiating COVID-19 pneumonia from acute respiratory distress syndrome and high altitude pulmonary edema: therapeutic implications. Circulation. 2020;142(2):101-104.
  • Manaker S.Coronavirus disease 2019 (COVID-19): critical care and airway management issues. UpTo Date. https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-critical-care-and-airway-management-issues. Yayınlanma tarihi Kasım 2020. Erişim tarihi 10 Aralık 2020.
  • Thille AW, Muller G, Gacouin A et al. Effect of postextubation high-flow nasal oxygen with noninvasive ventilation vs high-flow nasal oxygen alone on reintubation among patients at high risk of extubation failure: a randomized clinical trial. JAMA. 2019;322(15):1465–75.
  • Xu Q, Wang T, Qin X, Jie Y, Zha L, Lu W. Early awake prone position combined with high-flow nasal oxygen therapy in severe COVID-19: a case series. Critical Care. https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-02991-7. Yayınlanma tarihi: 24 Mayıs 2020. https://doi.org/10.1186/s13054-020-02991-7.

COVID-19’da Oksijen Tedavisi

Year 2021, Issue: 14, 376 - 388, 31.08.2021

Emel Yıldız Sevil Alkan Murat Emre Tokur Canan Balcı

https://doi.org/10.38079/igusabder.838044

Abstract

Global sorunumuz olan koronavirüs hastalığı 2019 (Coronavirus Disease 2019 (COVID-19)) klinik seyri değişkendir. İleri yaş, hipertansiyon, diyabet, kronik akciğer hastalığı, astım, kronik böbrek hastalıkları, karaciğer hastalıkları, kanser, obezite ve sigara kullanımı risk faktörleridir. COVID-19 hastaların yaklaşık % 15'inde orta ila şiddetli hastalık gelişebilir ve hastaneye yatabilirler. Destek tedavisi olarak oksijen (O2) desteğine ihtiyaç duyabilirler. COVID-19 hastalarının % 5'inin ise bir yoğun bakım ünitesine (YBÜ) ihtiyacı olabilir. Arteriyel hipoksemi (arteriyel oksijen satürasyonu (SpO2) < %90, parsiyel O2 basıncı (PaO2) < 60 mmHg) varlığında akut oksijen tedavisi endikasyonu vardır. Hipotansiyon, metabolik asidoz ve solunum sıkıntısı durumlarında doku hipoksisi meydana gelir ve oksijen tedavisi gerekir. COVID-19 hastalarında dirençli bir hipoksi mevcuttur. Dirençli hipoksi hastalarda, nefes darlığı olmaksızın yaşamla uyumsuz SpO2 seviyeleri olarak tanımlanmaktadır. Bu durum hastaların yoğun bakım takip edilme isteklerini artırabilir. Fakat yoğun bakımların etkin ve efektif kullanılabilmesi için doğru endikasyondaki COVID-19 tanılı hastanın alınması ve servislerde takip edilebilecek hastaların servis takibi yapılması daha doğru bir yaklaşımdır. COVID-19 hastalarının özellikle riskli grubun nabız oksimetre ile SpO2 takibi önemlidir. Hastaların semptom vermeden önce tanı konularak etkin ve efektif O2 tedavisine başlanması sağlanmış olur. 

Keywords

oksijen covid-19 hipoksemi

References

  • Williamson EJ, Walker AJ, Bhaskaran K. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020;584:430–436.
  • Wang Z, Chen X, Lu Y, Chen F, Zhang W. Clinical features and treatment procedure for four cases of 2019 novel coronavirus pneumonia under United Chinese and Western medicine. BiosciTrends. 2020;14:64–68.
  • Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323:1061–1069.
  • McCallum K. Can an oximeter help detect COVID-19 at home? Houston Methodist Leading Medicine. https://www.houstonmethodist.org/blog/articles/2020/aug/can-an-oximeter-help-detect-COVID-19-at-home. Yayınlanma tarihi 12 Ağustos 2020. Erişim tarihi 12 Kasım 2020.
  • Shen C, Yue X, Wang J, Shi C, Lia W. Nocturnal oxygen therapy as an option for early COVID-19. Int J InfectDis. 2020;(98):176-179.
  • Ersoy EO, Topeli A. Solunum yetmezliğinde oksijen uygulama sistemleri. Yoğun Bakım Dergisi. 2016;(7):99-105.
  • Anthony J, Faugno MD, Scott K, Epstein MD. Acute Respiratory Failure. In: Rakel D. Conn's Current Therapy. 1st ed. Elsevier; 2020.
  • Dondorp AM, Hayat M, Aryal D, Beane A, Schultz MJ. Respiratory support in COVID-19 Patients, with a focus on resource-limited settings. Am. J. Trop. Med. Hyg. B 2020; (102):1191–1197.
  • Kipshidze N, Yeo N, Kipshidze N, et al. Photodynamic therapy for COVID-19. Nature Photonics. 2020;(14):651–652.
  • Hippo Education. What if I get called in: COVID Airway Management for the Non-Intensivist. Hippo Education. https://static1.squarespace.com/static/5e72685dcd1fd40606730364/t/5e974bc2c1c0dc4f75e7ca57/1586973695230/COVID+Airway+Management+for+the+Non-Intensivist_What+if+I+get+called+in.pdf. Yayınlanma tarihi 14 Nisan 2020. Erişim tarihi 12 Kasım 2020.
  • World Health Organisation. Clinical Management of Severe Acute Respiratory Infection (SARI) when COVID-19 Disease is Suspected - Interim Guidance. World Health Organisation. https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdfYayınlanma tarihi 13 Mart 2020. Erişim tarihi 12 Ekim 2020.
  • T.C. Sağlık Bakanlığı Bilimsel Danışma Kurulu Çalışması. COVID-19 (Sars-CoV-2 enfeksiyonu) Ağır Pnömoni, ARDS, Sepsis ve Septik Şok Yönetimi. T.C. Sağlık Bakanlığı. https://covid19.saglik.gov.tr/Eklenti/39297/0/covid-19rehberiagirpnomoniardssepsisveseptiksokyontemipdf.pdf. Yayınlanma tarihi 23 Ekim 2020.
  • Morrison M, Weingart S. What if I Get Called In...COVID Airway Management for the Non-Intensivist. Hippo Education. https://www.hippoed.com/pc/rap/episode/whatifiget/whatifiget. Yayınlanma tarihi 20 Nisan 2020. Erişim tarihi 11 Kasım 2020.
  • Liu W, Li H. COVID-19:Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism. ChemRxiv. https://chemrxiv.org/engage/chemrxiv/article-details/60c74fa50f50db305139743d. Yayınlanma tarihi 2020. https://doi.org/10.26434/chemrxiv.11938173.v9
  • Tobin MJ, Langhi F, Jubran A.Why Covid-19 silent hypoxemia is baffling to physicians. Am J Respir Crit Care Med. 2020;202(3):356–360.
  • Dhont S, Derom E, Braeckel EV, Depuydt P, Lambrecht BN. The pathophysiology of ‘happy’ hypoxemia in COVID-19. Respiratory Research. 2020;(21):198.
  • Peterson DD, Pack AI, Silage DA, Fishman AP. Effects of aging on ventilatory and occlusion pressure responses to hypoxia and hypercapnia. Am Rev Respir Dis. 1981;(124):387–391.
  • Goyal D, Donnelly H, Kussner A, et al. Oxygen and mortality in COVID-19 pneumonia: a comparative analysis of supplemental oxygen policies and health outcomes across 26 countries. Medrxiv. 2020:1-17.
  • Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of Coronavirus Disease 2019 in China. N Engl J Med.2020;(382):1708-1720.
  • Sardesai I, Grover J, Garg M, et al. Short term home oxygen therapy for COVID-19 patients: the COVID-HOT algorithm. J Family Med Prim Care. 2020; 9(7): 3209–3219.
  • Barrot L, Asfar P, Mauny F, et al. Liberal or conservative oxygen therapy for acute respiratory distress syndrome. N Engl J Med. 2020;382(11):999-1008.
  • Alhazzani W, Morten HM, Arabi YM, et al. Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med. 2020;46(5):854-887.
  • Ni YN, Luo J, Yu H, et al. The effect of high-flow nasal cannula in reducing the mortality and the rate of endotracheal intubation when used before mechanical ventilation compared with conventional oxygen therapy and noninvasive positive pressure ventilation. A systematic review and meta-analysis. Am J EmergMed. 2018;36(2):226-233.
  • Archer SL, Sharp WW, Weir EK. Differentiating COVID-19 pneumonia from acute respiratory distress syndrome and high altitude pulmonary edema: therapeutic implications. Circulation. 2020;142(2):101-104.
  • Manaker S.Coronavirus disease 2019 (COVID-19): critical care and airway management issues. UpTo Date. https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-critical-care-and-airway-management-issues. Yayınlanma tarihi Kasım 2020. Erişim tarihi 10 Aralık 2020.
  • Thille AW, Muller G, Gacouin A et al. Effect of postextubation high-flow nasal oxygen with noninvasive ventilation vs high-flow nasal oxygen alone on reintubation among patients at high risk of extubation failure: a randomized clinical trial. JAMA. 2019;322(15):1465–75.
  • Xu Q, Wang T, Qin X, Jie Y, Zha L, Lu W. Early awake prone position combined with high-flow nasal oxygen therapy in severe COVID-19: a case series. Critical Care. https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-02991-7. Yayınlanma tarihi: 24 Mayıs 2020. https://doi.org/10.1186/s13054-020-02991-7.
There are 27 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Articles
Authors

Emel Yıldız 0000-0003-4493-2099

Sevil Alkan 0000-0003-1944-2477

Murat Emre Tokur 0000-0002-3957-4971

Canan Balcı 0000-0002-3318-8455

Publication Date August 31, 2021
Acceptance Date July 25, 2021
Published in Issue Year 2021 Issue: 14

Cite

JAMA Yıldız E, Alkan S, Tokur ME, Balcı C. COVID-19’da Oksijen Tedavisi. IGUSABDER. 2021;:376–388.
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