Clinical heavy patients of COVID 19 are characterized by disturbance of food. Providing food is vital, especially at a complication infections and organ insufficiency. Sepsis — one of therapeutic states at which nutritive support leads to decrease in the time spent of patients in ORIT and lethality. Considering that the average duration of IVL at patients with COVID 19 is about 14 days, these patients are in a zone of risk of a hypotrophy.

The high-line nasal cannula (HFNC) is usually used at treatment of hypoxemic respiratory insufficiency and is connected with бóльшим the number of days without connection to the ventilator and lower mortality in comparison with a standard oxygenotherapy or noninvasive ventilation.

COVID-19 within a pandemic negatively influences today pregnant patients worldwide. Though at most of patients heavy disease is not noted, at some it nevertheless is shown. The purpose of this article — to formulate the actions for respiratory support recommended for the infected pregnant patients with a heavy acute respiratory syndrome of SARS-CoV-2.

The patients who are on a hemodialysis represent risk group concerning COVID-19. To increase safety of sessions of a hemodialysis for such patients, it is necessary to follow a number of rules.

It is necessary to inform all dialysis patients on signs and symptoms of a koronavirusny infection and on general measures of precaution, including such measures as observance of rules of conduct at respiratory cough, hygiene of hands and social distancing.

The syndrome of acute respiratory insufficiency (ARDS) usually develops after the eclipse period lasting several hours or days after influence of a factor. The progressing respiratory insufficiency is connected with the pathological manifestations caused by disturbance of integrity of alveolar capillaries in lungs and transuding of proteinaceous transudate in alveolar space. The health worker has to distinguish heavy hypoxemic respiratory insufficiency in case of absence at the patient of the answer to a standard oxygen therapy or FIELDS and to be prepared for rendering expanded oxygen and ventilating support.

As the available data testify, at many patients hypoxemic respiratory insufficiency at COVID-19 can differ from acute respiratory a distress syndrome in its more classical look (ARDS). Though in many cases considerable loss of residual volume is observed, the pulmonary extensibility (komplayns) at a considerable part of patients sufficiently remains at high degree of alveolar dead space that gives the grounds to assume damage of a reflex of hypoxemic pulmonary vasoconstriction or others, the mechanisms which are not investigated yet.

The important point determining the accuracy of carrying out researches on COVID-19 is the correct intake of material for carrying out a research. At the wrong intake of material, its wrong storage or transportation, the risk of false-negative results is high that can lead to wrong diagnostics and refusal of holding anti-epidemic actions where they are shown.

Preliminary oxygenation is obligatory for patients with COVID-19 because of risk of fast decrease in level of saturation of hemoglobin of an arterial blood oxygen. After optimization of position of the patient and correction of hemodynamic disturbances execute preliminary oxygenation with fraction of the inhaled oxygen of 100% within not less than 3 minutes at active breath or eight breaths, each of which is equal to the vital capacity of lungs.

Early identification

Probability of early identification of COVID-19 among patients can be increased as follows:

Visual estimate of a state and sorting of patients for identification of the persons having symptoms of the acute respiratory disease (ARD);

Point of primary survey and sorting it is necessary to arrange on an entrance to reception and also on all entrances to the building of medical institution;

During COVID-19 epidemic at the pregnant women having planned examinations and procedures it is necessary to collect in a routine order detailed data on recent trips, on an occupation, on potentially dangerous contacts and stay in regions with the high level of an infection and also about existence of clinical signs of a disease.