Respiratory distress is a particularly common symptom in hospitalized patients with COVID-19. Many are given oxygen to support their breathing for this reason. A distinction is made between invasive and non-invasive methods of ventilation.

The non-invasive methods include the use of a face mask and the delivery of high dose oxygen via the nose (known as High Flow Nasal Oxygen Therapy). In these methods, oxygen is supplied at slightly increased pressure so that it is pushed into the upper airways.

With invasive ventilation, the patients are usually unconscious. In a procedure known as intubation, a pipe is inserted into the trachea (windpipe) through the mouth or a tracheostomy (incision in the trachea) so that the air from the ventilator is delivered directly into the lungs. Before intubation, the patient is put into an induced coma and he/she then remains unconscious throughout the ventilation period. Patients are often positioned lying face down during ventilation to improve the supply of oxygen to the rear areas of the lungs.

ECMO (extra-corporeal membrane oxygenation) devices are also known as artificial lungs because they allow oxygen uptake to happen outside the body. These devices may also be used in the invasive ventilation of COVID-19 patients if their lung tissue is no longer able to take up oxygen. In ECMO, the patient’s blood is pumped through the device so that carbon dioxide can be removed and oxygen added. The treated blood is then put back into the patient’s blood vessels.

According to the Robert Koch Institute (RKI) more than one in every two COVID-19 patients in ICUs (56%) needs invasive ventilation.

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