Supportive Management and Interventions for Respiratory Failure Due to SARS-CoV-2

Evolution of Acute Respiratory Distress Syndrome in Emergency and Critical Care: Therapeutic Management before and during the Pandemic Situation

Background and Objectives: Acute respiratory distress syndrome is a life-threatening lung condition that prevents enough oxygen from getting to the lungs and blood. The causes can be varied, although since the COVID-19 pandemic began there have been many cases related to this virus. The management and evolution of ARDS in emergency situations in the last 5 years was analyzed. Materials and Methods: A systematic review was carried out in the PubMed and Scopus databases. Using the descriptors Medical Subject Headings (MeSH), the search equation was: "Emergency health service AND acute respiratory distress syndrome". The search was conducted in December 2021. Quantitative primary studies on the care of patients with ARDS in an emergency setting published in the last 5 years were included. Results: In the initial management, adherence to standard treatment with continuous positive airway pressure (CPAP) is recommended. The use of extracorporeal membrane reduces the intensity of mechanical ventilation or as rescue therapy in acute respiratory distress syndrome (ARDS). The prone position in both intubated and non-intubated patients with severe ARDS is associated with a better survival of these patients, therefore, it is very useful in these moments of pandemic crisis. Lack of resources forces triage decisions about which patients are most likely to survive to start mechanical ventilation and this reflects the realities of intensive care and emergency care in a resource-limited setting. Conclusions: adequate prehospital management of ARDS and in emergency situations can improve the prognosis of patients. The therapeutic options in atypical ARDS due to COVID-19 do not seem to vary substantially from conventional ARDS.

The Way of Severe Nursing of Respiratory System Failure

Respiratory failure is the most common clinical symptom, seriously endangering people's health, which is mainly caused by a series of reasons, leading to serious respiratory dysfunction and severe pulmonary respiratory disorders, damaging the pulmonary airway function, and causing disability to maintain normal human gas exchange activities. At present, the main treatment of respiratory failure is to use the ventilator to help patients exchange gas and keep their breathing unobstructed. The nursing method is also around the artificial airway mechanical ventilation. The nursing of patients with respiratory failure is mainly respiratory nursing and psychological nursing. In this paper, the main research is to explore the way of severe nursing of respiratory failure. Before the nursing of respiratory failure, we should carry out nursing detection of the ventilator and test its performance, tightness, pipeline safety, and airway patency. Then carrying on the respiratory failure mechanical ventilation nursing and clarifying its mechanical ventilation nursing process is the main work of intensive care, at the same time, giving consideration to the psychological nursing of respiratory failure and implementing comprehensive nursing. In this paper, 50 patients were selected and divided into group A and group B; group A was given comprehensive nursing, and group B was given general nursing. The experimental results show that a series of situations in group A are more optimistic than those in group B. There was no doubt that the PH value of the two groups changed significantly 6 months after discharge. The pO2 value of group A was higher than that before discharge, while the pCO2 value of group B was unstable and increased. The pO2 value of group A was 55.52 before discharge and 62.36 six months after discharge. The pCO2 value of group A was 54.31 before discharge and 50.61 six months after discharge. The pCO2 value of group B was 55.23 before discharge and 57.34 six months after discharge.