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Successful treatment of a critically ill patient with acute respiratory distress syndrome from COVID-19 using mechanical ventilation strategy with low levels of positive end-expiratory pressure: A CARE-compliant case report
Authors:Wei-guang Guo  Bin Fang  Yan-shan Xian  Zhi-hui Yu  Li-xin Zhou
Institution:Department of Critical Care Medicine of Foshan first people''s Hospital, Foshan, 528000, Guangdong Province, China.
Abstract:Introduction:Acute respiratory distress syndrome (ARDS) secondary to COVID-19 is different from the ARDS caused by other infections. Conventional mechanical ventilation strategies using high levels of PEEP may not be beneficial and can even be harmful to patient with ARDS from COVID-19. So the ventilation strategies should be adjusted in order to improve the pulmonary ventilation function and oxygenation status, and outcomes of the patient.Patient concerns:Herein, we present a 76-year-old male patient with ARDS secondary to COVID-19. We describe our experience with mechanical ventilation strategy and the changes in respiratory mechanics in the patient during treatment.Diagnosis:The patient had tested positive for coronavirus (COVID-19) in nucleic acid test. Chest CT showed multiple ground glass shadows in both lungs.Interventions:The patient received mechanical ventilation with low tidal volume and low PEEP.Outcomes:After treatment, the patients condition, as well as oxygenation status was improved, and he tested negative for the coronavirus several times.Conclusion:This case demonstrated that the low tidal volume with low levels of PEEP ventilation strategy may be more suitable for ARDS from COVID-19.
Keywords:COVID-19  low positive end-expiratory pressure level  low tidal volume  mechanical ventilation strategy  oxygenation status  pulmonary ventilation function
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