Quais as estratégias de ventilação pulmonar na síndrome do desconforto respiratório agudo causada pela COVID-19?: estudo de revisão

Abstract

In late 2019, a group of cases of pneumonia associated with a new coronavirus, SARS-Cov-2, emerged, spreading across the world and being labeled a global pandemic by COVID-19. Most patients will not require hospitalization, while others may present complications such as acute respiratory distress syndrome (ARDS), requiring the use of invasive mechanics (IMV). Patients with ARDS due to COVID-19 may have specific characteristics compared to the typical forms of the syndrome, developing distinct phenotypes that have yet to be studied. Research has, therefore, focused on clarifying lung protective preventive measures (PPE) for these patients. This study was a narrative review aiming to investigate the current world experience in relation to PPE as the management of ARDS associated with COVID-19 and to highlight IMV practices during a pandemic. After a process of identification, selection, eligibility and inclusion of the studies screened in the PubMed and BVS databases, 20 studies were selected to be imposed, publications from 2019 to 2020. From this, a qualitative summary of the studies was performed. In most studies, the ventilatory management of patients is similar to the “classic” ARDS and, therefore, a PPE stood out as an important ally in the regression of ARDS in patients COVID 19. However, the phenotypic heterogeneity of patients must be taken into account, especially regarding pulmonary mechanics and recruitment capacity. This study allowed for a scientific deepening of the similarities and differences of ARDS due to COVID-19 and other causes, in addition to allowing the formation of guidelines regarding initial ventilatory adjustments in patients with ARDS / COVID-19.