Oxygen Therapy in COVID-19

Öz

The clinical course of our global problem, coronavirus-associated disease 2019 (COVID-19), is variable. Older age, hypertension, diabetes, chronic lung disease, asthma, chronic kidney diseases, liver diseases, cancer, obesity and smoking are risk factors. Approximately 15% of patients with COVID-19 develop moderate to severe illness and require hospitalization and O2 support; 5% may need an intensive care (ICU). Approximately 15% of patients with COVID-19 develop moderate to severe disease and require hospitalization and O2 support; 5% may need in intensive care units (ICUs). Acute O2 therapy is indicated in cases of arterial hypoxemia (arterial oxygen saturation (SpO2) <90%, Pa O2<60 mmHg), tissue hypoxia, hypotension, metabolic acidosis and respiratory distress. COVID-19 patients have persistent hypoxia. In resistant hypoxia patients, it is defined as SpO2 levels that are incompatible with life without shortness of breath. This may increase the desire of patients to be followed in ICU. However, in order to use ICU effectively and effectively, it is a more correct approach to recruit a patient with a diagnosis of COVID-19 with the correct indication and to follow-up the patients who can be followed in the services. Pulse oximetry and SpO2 monitoring of COVID-19 patients, especially the risky group, is important. Patients are diagnosed before they give symptoms and O2 treatment is initiated.

Anahtar Kelimeler

• oxygen
• covid-19
• hypoxemia

COVID-19’da Oksijen Tedavisi

Öz

Global sorunumuz olan koronavirüs hastalığı 2019 (Coronavirus Disease 2019 (COVID-19)) klinik seyri değişkendir. İleri yaş, hipertansiyon, diyabet, kronik akciğer hastalığı, astım, kronik böbrek hastalıkları, karaciğer hastalıkları, kanser, obezite ve sigara kullanımı risk faktörleridir. COVID-19 hastaların yaklaşık % 15'inde orta ila şiddetli hastalık gelişebilir ve hastaneye yatabilirler. Destek tedavisi olarak oksijen (O2) desteğine ihtiyaç duyabilirler. COVID-19 hastalarının % 5'inin ise bir yoğun bakım ünitesine (YBÜ) ihtiyacı olabilir. Arteriyel hipoksemi (arteriyel oksijen satürasyonu (SpO2) < %90, parsiyel O2 basıncı (PaO2) < 60 mmHg) varlığında akut oksijen tedavisi endikasyonu vardır. Hipotansiyon, metabolik asidoz ve solunum sıkıntısı durumlarında doku hipoksisi meydana gelir ve oksijen tedavisi gerekir. COVID-19 hastalarında dirençli bir hipoksi mevcuttur. Dirençli hipoksi hastalarda, nefes darlığı olmaksızın yaşamla uyumsuz SpO2 seviyeleri olarak tanımlanmaktadır. Bu durum hastaların yoğun bakım takip edilme isteklerini artırabilir. Fakat yoğun bakımların etkin ve efektif kullanılabilmesi için doğru endikasyondaki COVID-19 tanılı hastanın alınması ve servislerde takip edilebilecek hastaların servis takibi yapılması daha doğru bir yaklaşımdır. COVID-19 hastalarının özellikle riskli grubun nabız oksimetre ile SpO2 takibi önemlidir. Hastaların semptom vermeden önce tanı konularak etkin ve efektif O2 tedavisine başlanması sağlanmış olur. 

Anahtar Kelimeler

• oksijen
• covid-19
• hipoksemi

Kaynakça

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