Table 3 Proposed respiratory support based on the severity of acute respiratory failure
From: COVID-19 multidisciplinary high dependency unit: the Milan model
Acute Respiratory failure | Alternative |
|---|---|
▪ P/F ratio > 300 and respiratory rate (RR) < 30 | ▪ Low-flow nasal cannula oxygen or Venturi Mask or Reservoir Mask set with the aim of target SpO2 92–96% |
▪ HFNC 40 L/min and FiO2 set with the aim of target SpO2 92–96% | |
▪ P/F ratio 100–300 and RR < 30 | ▪ Helmet CPAP with PEEP 5 or 7.5 cmH2O and FiO2 set with the aim of target SpO2 92–96% |
▪ P/F ratio < 100 and RR < 30 | ▪ Helmet CPAP with PEEP 5 or 7.5 cmH2O and FiO2 set with the aim of target SpO2 92–96% |
▪ P/F ratio < 100 and RR ≥ 30 and/or respiratory distress | ▪ NIV (Also to consider in case of: CPAP failure, hyper-capnia). NIV starting parameters: PEEP 12–16 cmH20 PS set with the aim of Vt 4–6 ml/kg and FiO2 set with the aim of target SpO2 90–95% |