It is known that at a koronavirusny infection the main target organ are lungs which are surprised in most cases this pathology. Therefore use of various methods of respiratory support as one of the most important methods of treatment of this disease is logical. Correctly carried out respiratory support is capable to liquidate a hypoxia, to provide an organism with enough oxygen and to influence a pathogenetic chain of an infection.
Considering the fact that damage of lungs at a koronavirusny infection in general is similar to defeat at acute respiratory a distress syndrome, attempts to treat this infection, and in particular, to provide respiratory support by the same principles on what were made in the beginning it is carried out at ORDS. However, enough it became clear soon that these pathologies differ among themselves. Besides, the early beginning of invasive respiratory support for a koronavirusny infection can lead to increase in lethality according to some authors and promotes use of the park of respirators that is important in the period of a pandemic. The last is very important at active load of healthcare institutions as in this case respirators which are available in limited quantity will be occupied by the heaviest patients at whom it is impossible to do without invasive respiratory support. Therefore in a context treatment of a koronavirusny infection huge significance is attached to noninvasive methods of respiratory support, such as as a usual oxygenotherapy, a high-line nasal oxygenotherapy, noninvasive ventilation of the lungs.
If to speak about a usual (standard) oxygenotherapy, then it is the simplest technique which is widely available in many hospitals and demands existence of a source of oxygen, a humidifier and a nasal cannula or a front mask. This technique allows to provide with oxygen considerable number of patients without the need for observation of them in the conditions of intensive care unit that is important at mass arrival of patients. In certain cases, at a lack of oxygen points, additional oxygen points can be mounted or be carried out distributing from the available oxygen points. In the latter case it must be kept in mind that circumstance that pressure and a stream of oxygen in case of distributing will decrease in proportion to number of patients who will use this distributing. In general, one may say, that carrying out usual oxygenotherapies will be required to most of patients from among those which came to a hospital with a koronavirusny infection.
The high-line nasal oxygenotherapy represents supply of oxygen in mix which moves a high stream to the patient through special nasal cannulas. At the same time the stream of mix can reach 60 l a minute that promotes not only oxygenation, but also elimination of carbon dioxide. Oxygen concentration in such mix can be close to 100% or below (depending on needs of the patient). In comparison with a usual oxygenotherapy it is more effective technique of noninvasive respiratory support which gained distribution a point a lack of a technique recently considerable planting of the environment is virus particles that leads to increase in virus load of personnel.
Noninvasive ventilation of the lungs represents a way of respiratory support which is carried out by a respirator through a front or nasal mask, at the same time preservation of spontaneous breath of the patient is required. The technique of maintenance of constant positive pressure in respiratory tracts is usually used that gives to the patient the chance to spend less efforts for a breath and also supports respiratory tracts abroach. The technique demands good cooperation with the patient and understanding of importance of the procedure by the last. It is necessary to carry high virus load of personnel to shortcomings of a technique.
As we see, the choice of methods of noninvasive respiratory support is rather high also depending on a condition of the patient, equipment of clinic, the number of patients, loads of personnel and other factors this or that of them can be used. In many cases the quality of noninvasive respiratory support increases when using a pron-position. Recommendations to use all possible ways of noninvasive respiratory support and to intubate the patient only in case of inefficiency of noninvasive techniques are available practically in all guides to treatment of a koronavirusny infection now. When carrying out noninvasive respiratory support monitoring of a condition of the patient has to be carried out.