Oxygen Level 80

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  1. Oxygen Level 80 Hospice
  2. Oxygen Level 80 On A Adult
  3. Oxygen Level 80-85
  4. Oxygen Level 80 Elderly

That’s why it’s so important to understand how to measure your current oxygen level—and determine whether it falls within an acceptable range. Why does oxygen level drop. It is not our intention to serve as a substitute for medical advice and any content posted should not be used for medical advice, diagnosis or treatment. While we encourage individuals to share their personal experiences with COPD, please consult a physician before making changes to your own COPD.

Hypoxemia

Overview

What is hypoxemia?

Hypoxemia occurs when levels of oxygen in the blood are lower than normal. If blood oxygen levels are too low, your body may not work properly.

  • Blood Oxygen Level Dependency — (BOLD) ist ein bildgebendes Verfahren der funktionellen Magnetresonanztomografie (fMRT), mittels dessen sich lokale.
  • One warning - incorrect administration of supplemental oxygen to patients with severe COPD can be fatal (I don’t mean gradually, I mean dying right then and there). The other answers given are very good, but unless I missed it somewhere, no one me.

Blood carries oxygen to the cells throughout your body to keep them healthy. Hypoxemia can cause mild problems such as headaches and shortness of breath. In severe cases, it can interfere with heart and brain function. Hypoxemia that causes low oxygen levels in your body’s tissues is called hypoxia. Sometimes people use the two terms interchangeably, but they are not the same thing.

Symptoms and Causes

What causes hypoxemia?

A variety of conditions and circumstances can interfere with the body’s ability to deliver normal levels of oxygen to the blood. Some of the most common causes of hypoxemia include:

  • Heart conditions, including heart defects
  • Lung conditions such as asthma, emphysema, and bronchitis
  • Locations of high altitudes, where oxygen in the air is lower
  • Strong pain medications or other problems that slow breathing
  • Sleep apnea (impaired breathing during sleep)
  • Inflammation or scarring of the lung tissue (as in pulmonary fibrosis)

What are the symptoms of hypoxemia?

Symptoms of hypoxemia vary depending on the severity of the condition. They include:

  • Shortness of breath
  • Fast heartbeat
  • Coughing
  • Confusion
  • Bluish color in skin, fingernails, and lips

Diagnosis and Tests

How do doctors diagnose hypoxemia?

To diagnose hypoxemia, your doctor will do a physical examination to listen to your heart and lungs. Abnormalities in these organs can be a sign of low blood oxygen. Your doctor may also check to see if your skin, lips, or fingernails look bluish.

Doctors use tests to check your oxygen levels, including:

  • Pulse oximetry: A sensor that slips over your finger measures the amount of oxygen in your blood. Pulse oximetry is painless and noninvasive. Many doctors use it routinely each time you visit.
  • Arterial blood gas test: A needle is used to take a blood sample from your artery to measure the levels of oxygen in your blood.
  • Other breathing tests: These might involve breathing into tubes that are connected to computers or other machines.

Management and Treatment

How do doctors treat hypoxemia?

Treatment for hypoxemia aims to raise the levels of oxygen in the blood. Doctors can use medications to treat underlying conditions that cause hypoxemia. These medications are often given through an inhaler that enables you to breathe the medicine into your lungs.

In more severe cases, your doctor may prescribe oxygen therapy. People typically receive extra oxygen through a device called a cannula (tube) that is clipped to the outside of the nose, or through a breathing mask. The location and amount of time people receive oxygen therapy is based on individual needs. You may receive oxygen at home, with a portable machine while you travel, or in the hospital.

What are the complications or side effects of hypoxemia?

If your blood does not have enough oxygen, it cannot deliver enough oxygen to the organs and tissues that need it. This situation can be fatal if severe in the short term and can affect the heart or brain if it persists over a long period of time.

Prevention

Can hypoxemia be prevented?

There are steps you can take to prevent hypoxemia from returning after treatment. To increase the oxygen levels in your blood, your doctor may recommend:

  • Deep breathing exercises
  • Mild exercise such as walking or yoga
  • Eating a healthy diet
  • Drinking plenty of water
  • Quitting smoking

Outlook / Prognosis

What is the outlook for people with hypoxemia?

Hypoxemia symptoms can go away with treatment. Depending on the cause, people with hypoxemia may require treatment once or on an ongoing basis. Your doctor will work with you to manage the condition so you can live an active, healthy life.

Living With

When should I call a doctor regarding hypoxemia?

Contact your doctor if you experience symptoms of hypoxemia. Netopia network & wireless cards driver download. Early diagnosis and treatment can help ensure the condition does not get worse and cause dangerous complications.

Last Updated: December 17, 2020

The COVID-19 Treatment Guidelines Panel’s (the Panel’s) recommendations below emphasize recommendations from the Surviving Sepsis Campaign Guidelines for adult sepsis, pediatric sepsis, and COVID-19.

Nonmechanically Ventilated Adults With Hypoxemic Respiratory Failure

Recommendations

  • For adults with COVID-19 and acute hypoxemic respiratory failure despite conventional oxygen therapy, the Panel recommends high-flow nasal cannula (HFNC) oxygen over noninvasive positive pressure ventilation (NIPPV) (BIIa).
  • In the absence of an indication for endotracheal intubation, the Panel recommends a closely monitored trial of NIPPV for adults with COVID-19 and acute hypoxemic respiratory failure and for whom HFNC is not available (BIIa).
  • For patients with persistent hypoxemia despite increasing supplemental oxygen requirements in whom endotracheal intubation is not otherwise indicated, the Panel recommends considering a trial of awake prone positioning to improve oxygenation (CIIa).
  • The Panel recommends against using awake prone positioning as a rescue therapy for refractory hypoxemia to avoid intubation in patients who otherwise meet the indications for intubation and mechanical ventilation (AIII).
  • If intubation becomes necessary, the procedure should be performed by an experienced practitioner in a controlled setting due to the enhanced risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure to health care practitioners during intubation (AIII).

Rationale

Severe illness in COVID-19 typically occurs approximately 1 week after the onset of symptoms. The most common symptom is dyspnea, which is often accompanied by hypoxemia. Patients with severe disease typically require supplemental oxygen and should be monitored closely for worsening respiratory status because some patients may progress to acute respiratory distress syndrome (ARDS).

Goal of Oxygenation

The optimal oxygen saturation (SpO2) in adults with COVID-19 is uncertain. However, a target SpO2 of 92% to 96% seems logical considering that indirect evidence from experience in patients without COVID-19 suggests that an SpO2 <92% or >96% may be harmful.

Regarding the potential harm of maintaining an SpO2 <92%, a trial randomly assigned ARDS patients without COVID-19 to either a conservative oxygen strategy (target SpO2 of 88% to 92%) or a liberal oxygen strategy (target SpO2 ≥96%). The trial was stopped early due to futility after enrolling 205 patients, but in the conservative oxygen group there was increased mortality at 90 days (between-group risk difference of 14%; 95% CI, 0.7% to 27%) and a trend toward increased mortality at 28-days (between-group risk difference of 8%; 95% CI, -5% to 21%).1

Regarding the potential harm of maintaining an SpO2 >96%, a meta-analysis of 25 randomized trials involving patients without COVID-19 found that a liberal oxygen strategy (median SpO2 of 96%) was associated with an increased risk of in-hospital mortality compared to a lower SpO2 comparator (relative risk 1.21; 95% CI, 1.03–1.43).2 Download citrix receiver 4.7 for windows 10.

Acute Hypoxemic Respiratory Failure

Oxygen Level 80 Hospice

In adults with COVID-19 and acute hypoxemic respiratory failure, conventional oxygen therapy may be insufficient to meet the oxygen needs of the patient. Options for providing enhanced respiratory support include HFNC, NIPPV, intubation and invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).

High-Flow Nasal Cannula and Noninvasive Positive Pressure Ventilation

HFNC is preferred over NIPPV in patients with acute hypoxemic respiratory failure based on data from an unblinded clinical trial in patients without COVID-19 who had acute hypoxemic respiratory failure. Study participants were randomized to HFNC, conventional oxygen therapy, or NIPPV. The patients in the HFNC group had more ventilator-free days (24 days) than those in the conventional oxygen therapy group (22 days) or NIPPV group (19 days) (P = 0.02), and 90-day mortality was lower in the HFNC group than in either the conventional oxygen therapy group (HR 2.01; 95% CI, 1.01–3.99) or the NIPPV group (HR 2.50; 95% CI, 1.31–4.78).3 In the subgroup of more severely hypoxemic patients (PaO2/FiO2 mm Hg ≤200), the intubation rate was lower for HFNC than for conventional oxygen therapy or NIPPV (HR 2.07 and 2.57, respectively).

The trial’s findings were corroborated by a meta-analysis of eight trials with 1,084 patients conducted to assess the effectiveness of oxygenation strategies prior to intubation. Compared to NIPPV, HFNC reduced the rate of intubation (OR 0.48; 95% CI, 0.31–0.73) and ICU mortality (OR 0.36; 95% CI, 0.20–0.63).4

NIPPV may generate aerosol spread of SARS-CoV-2 and thus increase nosocomial transmission of the infection.5,6 It remains unclear whether HFNC results in a lower risk of nosocomial SARS-CoV-2 transmission than NIPPV.

Prone Positioning for Nonintubated Patients

Although prone positioning has been shown to improve oxygenation and outcomes in patients with moderate-to-severe ARDS who are receiving mechanical ventilation,7,8 there is less evidence regarding the benefit of prone positioning in awake patients who require supplemental oxygen without mechanical ventilation. In a case series of 50 patients with COVID-19 pneumonia who required supplemental oxygen upon presentation to a New York City emergency department, awake prone positioning improved the overall median oxygen saturation of the patients. However, 13 patients still required intubation due to respiratory failure within 24 hours of presentation to the emergency department.9 Other case series of patients with COVID-19 requiring oxygen or NIPPV have similarly reported that awake prone positioning is well-tolerated and improves oxygenation,10-12 with some series also reporting low intubation rates after proning.10,12

A prospective feasibility study of awake prone positioning in 56 patients with COVID-19 receiving HFNC or NIPPV in a single Italian hospital found that prone positioning for ≤3 hours was feasible in 84% of the patients. There was a significant improvement in oxygenation during prone positioning (PaO2/FiO2 181 mm Hg in supine position vs. PaO2/FiO2 286 mm Hg in prone position). However, when compared with baseline oxygenation before initiation of prone positioning, this improvement in oxygenation was not sustained (PaO2/FiO2 of 181 mm Hg and 192 mm Hg at baseline and 1 hour after resupination, respectively). Among patients put in the prone position, there was no difference in intubation rate between patients who maintained improved oxygenation (i.e., responders) and nonresponders.9

A prospective, multicenter observational cohort study in Spain and Andorra evaluated the effect of prone positioning on the rate of intubation in COVID-19 patients with acute respiratory failure receiving HFNC. Of the 199 patients requiring HFNC, 55 (27.6%) were treated with prone positioning. Although the time to intubation was 1 day (IQR 1.0–2.5) in patients receiving HFNC and prone positioning versus 2 days [IQR 1.0–3.0] in patients receiving only HFNC (P = 0.055), the use of awake prone positioning did not reduce the risk of intubation (RR 0.87; 95% CI, 0.53–1.43; P = 0.60).13

Overall, despite promising data, it is unclear which hypoxemic, nonintubated patients with COVID-19 pneumonia benefit from prone positioning, how long prone positioning should be continued, or whether the technique prevents the need for intubation or improves survival.10

Appropriate candidates for awake prone positioning are those who can adjust their position independently and tolerate lying prone. Awake prone positioning is contraindicated in patients who are in respiratory distress and who require immediate intubation. Awake prone positioning is also contraindicated in patients who are hemodynamically unstable, patients who recently had abdominal surgery, and patients who have an unstable spine.14 Awake prone positioning is acceptable and feasible for pregnant patients and can be performed in the left lateral decubitus position or the fully prone position.15

Intubation for Invasive Mechanical Ventilation

It is essential to monitor hypoxemic patients with COVID-19 closely for signs of respiratory decompensation. To ensure the safety of both patients and health care workers, intubation should be performed in a controlled setting by an experienced practitioner.

Mechanically Ventilated Adults

Recommendations

For mechanically ventilated adults with COVID-19 and ARDS:

  • The Panel recommends using low tidal volume (VT) ventilation (VT 4–8 mL/kg of predicted body weight) over higher VT ventilation (VT >8 mL/kg) (AI).
  • The Panel recommends targeting plateau pressures of <30 cm H2O (AIIa).
  • The Panel recommends using a conservative fluid strategy over a liberal fluid strategy (BIIa).
  • The Panel recommends against the routine use of inhaled nitric oxide (AIIa).

Rationale

Oxygen Level 80 On A Adult

There is no evidence that ventilator management of patients with hypoxemic respiratory failure due to COVID-19 should differ from ventilator management of patients with hypoxemic respiratory failure due to other causes.

Positive End-Expiratory Pressure and Prone Positioning in Mechanically Ventilated Adults With Moderate to Severe Acute Respiratory Distress Syndrome

Recommendations

For mechanically ventilated adults with COVID-19 and moderate-to-severe ARDS:

  • The Panel recommends using a higher positive end-expiratory pressure (PEEP) strategy over a lower PEEP strategy (BIIa).
  • For mechanically ventilated adults with COVID-19 and refractory hypoxemia despite optimized ventilation, the Panel recommends prone ventilation for 12 to 16 hours per day over no prone ventilation (BIIa).

Rationale

Oxygen Level 80

PEEP is beneficial in patients with ARDS because it prevents alveolar collapse, improves oxygenation, and minimizes atelectotrauma, a source of ventilator-induced lung injury. A meta-analysis of individual patient data from the three largest trials that compared lower and higher levels of PEEP in patients without COVID-19 found lower rates of ICU mortality and in-hospital mortality with higher PEEP in those with moderate (PaO2/FiO2 100–200 mm Hg) and severe ARDS (PaO2/FiO2 <100 mm Hg).16

Although there is no clear standard as to what constitutes a high level of PEEP, one conventional threshold is >10 cm H2O.17 Recent reports have suggested that, in contrast to patients with non-COVID-19 causes of ARDS, some patients with moderate or severe ARDS due to COVID-19 have normal static lung compliance and thus, in these patients, higher PEEP levels may cause harm by compromising hemodynamics and cardiovascular performance.18,19 Other studies reported that patients with moderate to severe ARDS due to COVID-19 had low compliance, similar to the lung compliance seen in patients with conventional ARDS.20-23 These seemingly contradictory observations suggest that COVID-19 patients with ARDS are a heterogeneous population and assessment for responsiveness to higher PEEP should be individualized based on oxygenation and lung compliance. Clinicians should monitor patients for known side effects of higher PEEP, such as barotrauma and hypotension.

Neuromuscular Blockade in Mechanically Ventilated Adults With Moderate to Severe Acute Respiratory Distress Syndrome

Recommendations

For mechanically ventilated adults with COVID-19 and moderate-to-severe ARDS:

  • The Panel recommends using, as needed, intermittent boluses of neuromuscular blocking agents (NMBA) or continuous NMBA infusion to facilitate protective lung ventilation (BIIa).
  • In the event of persistent patient-ventilator dyssynchrony, or in cases where a patient requires ongoing deep sedation, prone ventilation, or persistently high plateau pressures, the Panel recommends using a continuous NMBA infusion for up to 48 hours as long as patient anxiety and pain can be adequately monitored and controlled (BIII).

Rationale

The recommendation for intermittent boluses of NMBA or continuous infusion of NMBA to facilitate lung protection may require a health care provider to enter the patient’s room frequently for close clinical monitoring. Therefore, in some situations, the risks of SARS-CoV-2 exposure and the need to use personal protective equipment for each entry into a patient’s room may outweigh the benefit of NMBA treatment.

Oxygen Level 80

Rescue Therapies for Mechanically Ventilated Adults With Acute Respiratory Distress Syndrome

Recommendations

For mechanically ventilated adults with COVID-19, severe ARDS, and hypoxemia despite optimized ventilation and other rescue strategies:

  • The Panel recommends using recruitment maneuvers rather than not using recruitment maneuvers (CIIa).
  • If recruitment maneuvers are used, the Panel recommends against using staircase (incremental PEEP) recruitment maneuvers (AIIa).
  • The Panel recommends using an inhaled pulmonary vasodilator as a rescue therapy; if no rapid improvement in oxygenation is observed, the treatment should be tapered off (CIII).

Oxygen Level 80-85

Rationale

There are no studies to date assessing the effect of recruitment maneuvers on oxygenation in severe ARDS due to COVID-19. However, a systematic review and meta-analysis of six trials of recruitment maneuvers in non-COVID-19 patients with ARDS found that recruitment maneuvers reduced mortality, improved oxygenation 24 hours after the maneuver, and decreased the need for rescue therapy.24 Because recruitment maneuvers can cause barotrauma or hypotension, patients should be closely monitored during recruitment maneuvers. If a patient decompensates during recruitment maneuvers, the maneuver should be stopped immediately. The importance of properly performing recruitment maneuvers was illustrated by an analysis of eight randomized controlled trials in non-COVID-19 patients (n = 2,544) which found that recruitment maneuvers did not reduce hospital mortality (RR 0.90; 95% CI, 0.78–1.04). Subgroup analysis found that traditional recruitment maneuvers significantly reduced hospital mortality (RR 0.85; 95% CI, 0.75–0.97), whereas incremental PEEP titration recruitment maneuvers increased mortality (RR 1.06; 95% CI, 0.97–1.17).25

Although there are no published studies of inhaled nitric oxide in patients with COVID-19, a Cochrane review of 13 trials of inhaled nitric oxide use in patients with ARDS found no mortality benefit.26 Because the review showed a transient benefit in oxygenation, it is reasonable to attempt inhaled nitric oxide as a rescue therapy in COVID patients with severe ARDS after other options have failed. However, if there is no benefit in oxygenation with inhaled nitric oxide, it should be tapered quickly to avoid rebound pulmonary vasoconstriction that may occur with discontinuation after prolonged use.

Oxygen Level 80 Elderly

  1. Barrot L, Asfar P, Mauny F, et al. Liberal or conservative oxygen therapy for acute respiratory distress syndrome. N Engl J Med. 2020;382(11):999-1008. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32160661.
  2. Chu DK, Kim LH, Young PJ, et al. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet. 2018;391(10131):1693-1705. Available at: https://www.ncbi.nlm.nih.gov/pubmed/29726345.
  3. Frat JP, Thille AW, Mercat A, et al. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med. 2015;372(23):2185-2196. Available at: https://www.ncbi.nlm.nih.gov/pubmed/25981908.
  4. Ni YN, Luo J, Yu H, Liu D, Liang BM, Liang ZA. The effect of high-flow nasal cannula in reducing the mortality and the rate of endotracheal intubation when used before mechanical ventilation compared with conventional oxygen therapy and noninvasive positive pressure ventilation. A systematic review and meta-analysis. Am J Emerg Med. 2018;36(2):226-233. Available at: https://www.ncbi.nlm.nih.gov/pubmed/28780231.
  5. Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One. 2012;7(4):e35797. Available at: https://www.ncbi.nlm.nih.gov/pubmed/22563403.
  6. Yu IT, Xie ZH, Tsoi KK, et al. Why did outbreaks of severe acute respiratory syndrome occur in some hospital wards but not in others? Clin Infect Dis. 2007;44(8):1017-1025. Available at: https://www.ncbi.nlm.nih.gov/pubmed/17366443.
  7. Guerin C, Reignier J, Richard JC, et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med. 2013;368(23):2159-2168. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23688302.
  8. Fan E, Del Sorbo L, Goligher EC, et al. An official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 2017;195(9):1253-1263. Available at: https://www.ncbi.nlm.nih.gov/pubmed/28459336.
  9. Caputo ND, Strayer RJ, Levitan R. Early self-proning in awake, non-intubated patients in the emergency department: a single ED's experience during the COVID-19 pandemic. Acad Emerg Med. 2020;27(5):375-378. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32320506.
  10. Sun Q, Qiu H, Huang M, Yang Y. Lower mortality of COVID-19 by early recognition and intervention: experience from Jiangsu Province. Ann Intensive Care. 2020;10(1):33. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32189136.
  11. Elharrar X, Trigui Y, Dols AM, et al. Use of prone positioning in nonintubated patients With COVID-19 and hypoxemic acute respiratory failure. JAMA. 2020;323(22):2336-2338. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32412581.
  12. Sartini C, Tresoldi M, Scarpellini P, et al. Respiratory parameters in patients with COVID-19 after using noninvasive ventilation in the prone position outside the intensive care unit. JAMA. 2020;323(22):2338-2340. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32412606.
  13. Ferrando C, Mellado-Artigas R, Gea A, et al. Awake prone positioning does not reduce the risk of intubation in COVID-19 treated with high-flow nasal oxygen therapy: a multicenter, adjusted cohort study. Crit Care. 2020;24(1):597. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33023669.
  14. Bamford P, Bentley A, Dean J, Whitmore D, Wilson-Baig N. ICS guidance for prone positioning of the conscious COVID patient. Intensive Care Society. 2020. Available at: https://emcrit.org/wp-content/uploads/2020/04/2020-04-12-Guidance-for-conscious-proning.pdf. Accessed December 8, 2020.
  15. Society for Maternal Fetal Medicine. Management considerations for pregnant patients with COVID-19. 2020. Available at: https://s3.amazonaws.com/cdn.smfm.org/media/2336/SMFM_COVID_Management_of_COVID_pos_preg_patients_4-30-20_final.pdf. Accessed December 8, 2020.
  16. Briel M, Meade M, Mercat A, et al. Higher vs. lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA. 2010;303(9):865-873. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20197533.
  17. Alhazzani W, Moller MH, Arabi YM, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Crit Care Med. 2020;48(6):e440-e469. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32224769.
  18. Marini JJ, Gattinoni L. Management of COVID-19 respiratory distress. JAMA. 2020;323(22):2329-2330. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32329799.
  19. Tsolaki V, Siempos I, Magira E, Kokkoris S, Zakynthinos GE, Zakynthinos S. PEEP levels in COVID-19 pneumonia. Crit Care. 2020;24(1):303. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32505186.
  20. Bhatraju PK, Ghassemieh BJ, Nichols M, et al. COVID-19 in critically ill patients in the Seattle region - case series. N Engl J Med. 2020;382(21):2012-2022. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32227758.
  21. Cummings MJ, Baldwin MR, Abrams D, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet. 2020;395(10239):1763-1770. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32442528.
  22. Ziehr DR, Alladina J, Petri CR, et al. Respiratory pathophysiology of mechanically ventilated patients with COVID-19: a cohort study. Am JRespir Crit Care Med. 2020;201(12):1560-1564. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32348678.
  23. Schenck EJ, Hoffman K, Goyal P, et al. Respiratory mechanics and gas exchange in COVID-19 associated respiratory failure. Ann Am Thorac Soc. 2020;17(9):1158-1161. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32432896.
  24. Goligher EC, Hodgson CL, Adhikari NKJ, et al. Lung recruitment maneuvers for adult patients with acute respiratory distress syndrome. a systematic review and meta-analysis. Ann Am Thorac Soc. 2017;14(Supplement 4):S304-S311. Available at: https://www.ncbi.nlm.nih.gov/pubmed/29043837.
  25. Alhazzani W, Moller MH, Arabi YM, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med. 2020;46(5):854-887. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32222812.
  26. Gebistorf F, Karam O, Wetterslev J, Afshari A. Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) in children and adults. Cochrane Database Syst Rev. 2016(6):CD002787. Available at: https://www.ncbi.nlm.nih.gov/pubmed/27347773.