Non-invasive respiratory support for patients with novel coronavirus pneumonia: clinical efficacy and reduction in risk of infection transmission

摘要

Pneumonia caused by a novel coronavirus known as 2019 novel coronavirus disease (COVID-19) appeared in Wuhan, China in December 2019, and approximately 15% to 30% of patients developed acute respiratory distress syndrome within a short period of time. To reduce respiratory symptoms and improve prognosis, respiratory support is the most important means of life support, and non-invasive respiratory support systems, including various conventional oxygen therapies, non-invasive positive pressure ventilation (NPPV), and high-flow nasal cannula (HFNC), are most commonly used. However, their efficacy and safety remain unclear, and whether they increase the risk of aerosol dispersion and disease transmission is particularly controversial. Given that there are many similarities between COVID-19 pneumonia and severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), this study primarily discusses clinical indications and provides details regarding the prevention of nosocomial infections during NPPV and HFNC treatment of COVID-19 pneumonia based on previous clinical data on the use of these two therapies for SARS and MERS and our experience with the treatment of COVID-19 pneumonia.