23 July 2020
: Case report 
A 29-Year-Old Male with a Fatal Case of COVID-19 Acute Respiratory Distress Syndrome (CARDS) and Ventilator-Induced Lung Injury (VILI)
Unknown etiology, Challenging differential diagnosis, Management of emergency care
Smit S. Deliwala1ABCDEF*, Anoosha Ponnapalli1ABCD, Elfateh Seedahmed2CDEF, Mohammed Berrou2CDEF, Ghassan Bachuwa1CDEF, Arul Chandran2ABCDEFDOI: 10.12659/AJCR.926136
Am J Case Rep 2020; 21:e926136
Table 3. Oxygen strategies in COVID-19 pneumonia (CARDS) Type L and Type H.
| COVID-19 Pneumonia, Type L | Time Frame | COVID-19 Pneumonia, Type H |
|---|---|---|
| Nasal cannula, high-flow nasal cannula, continuous positive airway pressure (CPAP), non-invasive positive pressure ventilation (NIPPV), or awake proning to avoid increased respiratory efforts | Nasal cannula, high-flow nasal cannula, continuous positive airway pressure (CPAP), non-invasive positive pressure ventilation (NIPPV), or awake proning to avoid increased respiratory efforts | |
| Lower positive end-expiratory pressures (PEEP) (<10 cmH O), tidal volumes (7–9 mL/kg), maintain gas exchange and fluid balances. Proning only as a rescue maneuver. extracorporeal membrane oxygenation (ECMO) in severe COVID-19 patients | Higher positive end-expiratory pressures (PEEP) (<15 cmH2O), tidal volumes (5–7 mL/kg), maintain gas exchange and fluid balances. Initiate proning and extracorporeal membrane oxygenation (ECMO) if parameters met. Manage these patients as full-blown ARDS | |
| Avoid vigorous spontaneous increases in breathing, pressure swings with breathing trials towards the ending of the weaning process. The goal is to avoid ventilator-induced lung injury (VILI) and worsening edema. Initiate careful weaning measures | Avoid vigorous spontaneous increases in breathing, pressure swings with breathing trials towards the ending of the weaning process. The goal is to avoid ventilator-induced lung injury (VILI) and worsening edema. Initiate careful weaning measures |