The Basics of ARDS Mechanical Ventilatory Care for Cardiovascular Specialists

Rayner-Hartley, Erin; Miller, P. Elliott; Burstein, Barry; Bibas, Lior; Goldfarb, Michael; Rampersad, Penelope; van Diepen, Sean

The ongoing coronavirus disease 2019 (COVID-19) pandemic has placed pressure on healthcare systems and intensive care unit capacity worldwide. Respiratory insufficiency is the most common reason for hospital admission in patients with COVID-19. The most severe form of respiratory failure is acute respiratory distress syndrome (ARDS), which is associated with significant morbidity and mortality. Patients with ARDS are often treated with invasive mechanical ventilation according to established evidence-based and guideline recommended management strategies. With growing strain on critical care capacity, clinicians from diverse backgrounds, including cardiovascular specialists, may be required to help care for the growing number of patients with severe respiratory failure and ARDS. The aim of this article is to outline the fundamentals of ARDS diagnosis and management, including mechanical ventilation (MV), for the non-intensivist. In the absence of MV trials specifically in COVID-19 associated ARDS, the information presented is based on general ARDS trials.