key: cord-1010168-wn9508dq
authors: Hashemian, Seyed Mohammadreza; Khoundabi, Batoul; Tabarsi, Payam
title: Oxygenation Efforts for Iranian COVID-19 ARDS Patients: First 5-Day Crisis Experience Scenario
date: 2020-07-03
journal: Tanaffos
DOI: nan
sha: a62b389ecc0cccbab2d415a6b6195fc0ebc69535
doc_id: 1010168
cord_uid: wn9508dq

nan

As of February 29, 2020, Coronavirus Disease 2019 (COVID-19) is spreading more quickly in the world than in China where the virus first emerged in the central city of Wuhan at the end of last year. Upon the death of two patients due to COVID-19 in Qom province 19 February 2020, Iran officially announced the virus had been identified in the country. On 20 February 2020, the first COVID-2019 infected patient was confirmed in Tehran at Masih Daneshvari Hospital; our critical care team was involved in that determination. We also reported an additional 7 patients, all male, which were admitted to the ICU.

The patients' BMI mean was 32.3±4.31 kg/m 2 , with ages ranging from 25 to 60 years. Several methods were utilized for oxygenation related to condition patients including: Conventional Mask (CM), Reservoir Mask (RM), Non-Invasive Ventilation (NIV) and Nasal High Flow (NHF) (1). We tried to postpone the intubation regarding to the clinical mastication patients as much as possible. Patients can be difficult to intubate because of anatomy or circumstances surrounding the intubation (2). Out of 7 patients, 2 patients were intubated (Figure 1 ). The decision for intubation must take into account their complicated conditions, and also consideration of airway management skills and experience with intubators. It was not possible to use CM and RM (Figure 2 ). An abnormality was seen in chest radiographs of these 2 patients (Figure 3 ), and they finally died at the end of fifth day. Patient 3 had the best response to the treatment and in the third day while using CM, he was discharged from the ICU to the floor. For 4 other patients, NHF or NIV was replaced by CM and RM during the time.

ARDS criteria, Berlin score, also improved after the first day to the fifth day, so that severe ARDS proportion was decreased from 40% to 25% and 25% of patients in the fifth day were experienced a mild Berlin score (Figure 1 ). intermittent NIV did not result in a worse rate of treatment failure. Because HFNC presents some advantages, it may be used instead of NIV (4). Feb. 25

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