Reacquainting Cardiology With Mechanical Ventilation in Response to the COVID-19 Pandemic
Ann Gage, Andrew Higgins, Ran Lee, Muhammad Siyab Panhwar, Ankur Kalra
Abstract
Reports from countries struck by the coronavirus disease-2019 (COVID-19) pandemic have consistently highlighted physician shortages and the utilization of physicians not specifically trained in critical care to care for patients with COVID-19. Given the significant overlap between cardiology and critical care, cardiologists may be among the first physicians asked to step in to fill this shortage. If and when this occurs, a basic framework for recognition of acute respiratory failure, acute respiratory distress syndrome (ARDS), and initial ventilator management is imperative. The following is a brief review of ARDS and an overview of ventilator management designed to help ensure physician comfort and patient safety. Data from China suggest respiratory findings are common in patients who are positive for COVID-19. Pneumonia was present in 91.1% of cases, and 3.4% of all patients developed ARDS. Oxygen therapy was used in 41.3% of patients, and infection required mechanical ventilation in 6.1% of those infected (1). The incidence has been even higher in the Italian series, with up to 10% of infected patients in Lombardy developing ARDS (2). It is likely that many American physicians will be called on to treat pneumonia, hypoxemic respiratory failure, and ARDS, regardless of their specialty.