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Review
. 2022 May;71(5):333-339.
doi: 10.1007/s00101-022-01114-x. Epub 2022 Apr 9.

[Noninvasive respiratory support and invasive ventilation in COVID‑19 : Where do we stand today?]

[Article in German]
Ines Schroeder  1 , Michael Irlbeck  2 , Michael Zoller  2
Affiliations
Review

[Noninvasive respiratory support and invasive ventilation in COVID‑19 : Where do we stand today?]

[Article in German]
Ines Schroeder et al. Anaesthesist. 2022 May.

Erratum in

Abstract
in English, German

The controversy surrounding ventilation in coronavirus disease 2019 (COVID-19) continues. Early in the pandemic it was postulated that the high intensive care unit (ICU) mortality may have been due to too early intubation. As the pandemic progressed recommendations changed and the use of noninvasive respiratory support (NIRS) increased; however, this did not result in a clear reduction in ICU mortality. Furthermore, large studies on optimal ventilation in COVID-19 are lacking. This review article summarizes the pathophysiological basis, the current state of the science and the impact of different treatment modalities on the outcome. Potential factors that could undermine the benefits of noninvasive respiratory support are discussed. The authors attempt to provide guidance in answering the difficult question of when is the right time to intubate?

Die Kontroverse um das Thema Beatmung bei vorliegender „coronavirus disease 2019“ (COVID-19) hält an. Zu Beginn der Pandemie wurde postuliert, dass die hohe Letalität auf den Intensivstationen möglicherweise auf eine zu frühe Intubation zurückzuführen sei. Im Verlauf der Pandemie änderten sich die Empfehlungen der Fachgesellschaften, und die Häufigkeit der Anwendung von nichtinvasiver respiratorischer Unterstützung (NIRS) nahm zu. Weiterhin fehlen große Studien zur optimalen Beatmung von COVID-19-Patienten. Der vorliegende Übersichtsbeitrag fasst die pathophysiologischen Grundlagen, den aktuellen Stand der Wissenschaft und die Auswirkungen der unterschiedlichen Behandlungsmodalitäten auf das Outcome zusammen.

Keywords: Acute respiratory distress syndrome; Critical care; Invasive ventilation; Non-invasive ventilation; Prone position.

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