Clinical and morphological comparison of respiratory failure in patients with COVID-19 who died under different options of respiratory support

Authors

DOI:

https://doi.org/10.15587/2519-4798.2021.238093

Keywords:

SARS-nCoV-2, COVID-19, hypoxemic respiratory failure, acute respiratory distress syndrome, respiratory support, non-invasive lung ventilation

Abstract

The aim. Based on the study of the effect of invasive mechanical ventilation and NIV in the CPAP mode on the pathomorphosis of lung damage in patients with HRF caused by SARS-nCoV-2 and deaths in intensive care unit (ICU), determine the safest method of respiratory support.

Materials and methods. The study included morphological material from 20 patients with HRF caused by SARS-nCoV-2 (COVID-19) who died in ICU. Group 1 included patients who received non-invasive lung ventilation in CPAP mode through a face mask (n=10), group 2 - patients who underwent invasive ventilation (n=10). The prepared sections, 5 μm thick, were stained according to the Van Gizon method. Photomicrographs were taken using Zeiss ZENliteimaging. Data are presented as M [25-75] and P±Sp. Statistical analysis of the results was performed using the program “Statistica 10”. Significance of differences in indicators was assessed using the nonparametric Wilcoxon test, the parametric Student's test. The results were considered reliable at values of p<0.05.

Results The morphological structure of the lungs of patients of group 1 corresponded to the exudative phase of DAD with severe edematous-hemorrhagic syndrome, signs of interstitial pneumonia with desquamation of alveolocytes and the formation of hyaline membranes. In patients of group 2 in the lung tissue there was a picture of the proliferative phase of DAD with signs of interstitial pneumonia, and the development of focal fibrosing alveolitis. Thus, invasive mechanical ventilation, can accelerate the development of irreversible processes in the lungs in the form of fibrosing alveolitis and promote the formation of ventilator-associated pneumonia

Conclusions. CPAP NIV is a promising method of respiratory support in patients with ARDS caused by SARS-nCoV-2 virus (COVID-19), which needs further study

Author Biographies

Vita Skoryk, Kharkiv Medical Academy of Postgraduate Education

Postgraduate Student

Department of Anesthesiology, Pediatric Anesthesiology and Intensive Care

Volodymyr Korsunov, Kharkiv Medical Academy of Postgraduate Education

Doctor of Medical Sciences, Professor

Department of Anesthesiology, Pediatric Anesthesiology and Intensive Care

Tetiana Bocharova, Kharkiv National Medical University

PhD, Associate Professor

Department of Pathological Anatomy

Pavel Nartov, Kharkiv Medical Academy of Postgraduate Education

Doctor of Medical Sciences, Professor

Department of Infectious Diseases

Maslova Valentina, Kharkiv Medical Academy of Postgraduate Education

PhD, Associate Professor

Department of Infectious Diseases

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Published

2021-07-30

How to Cite

Skoryk, V., Korsunov, V., Bocharova, T., Nartov, P., & Valentina, M. . (2021). Clinical and morphological comparison of respiratory failure in patients with COVID-19 who died under different options of respiratory support. ScienceRise: Medical Science, (4(43), 4–12. https://doi.org/10.15587/2519-4798.2021.238093

Issue

No. 4(43) (2021)

Section

Medical Science

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Copyright (c) 2021 Vita Skoryk, Volodymyr Korsunov, Tetiana Bocharova, Pavel Nartov, Maslova Valentina

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