She works in Las Vegas, NV and 1 other location and specializes in Critical Care Medicine and Internal Medicine. Simran MATTA Cited by 3 of University of Nevada School of Medicine, Reno Read 1 publication Contact Simran MATTA. This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Matta graduated from the Maharashtra Institute of Medical Education & Research (Mimer) in 2008. The Southwest Respiratory and Critical Care Chronicles 2020 8(35):29–35 From: Bayhealth Hospital, Milford, Delaware Submitted: Accepted: Reviewer: Gilbert Berdine MD, Victor Test MD Conflicts of interest: none Challenges and controversies in COVID-19 respiratory failure. Keywords: Covid-19, early intubation, patient self-induced lung injury (P-SILI), pendelluft, lung stress/strain, H and L phenotypes, high tidal volume, low PEEPĪrticle citation: Matta SK. A physiologic approach is presented to counter the non-uniform and heterogeneous presentations of this unique disease rather than conforming to rigid protocols. The review suggests that the isolated ground glass opacities could pose as “stress raisers.” The effects of these regional lung homogeneities in amplifying local and global lung stress are also discussed as well as the benefits of PEEP beyond its effect as a pressure barrier against alveolar filling and its utility in lungs with near normal compliance. It considers the established facts of inducing lung strain with larger dynamic deformations caused by high tidal volumes and the benefit of high PEEP in homogenizing the strain distribution. This article also discusses the emerging controversial proposals of employing high tidal volumes and low PEEP in mechanical ventilation of COVID-19 pneumonia and will review the key concepts of lung stress and strain and the implications of “static” versus “dynamic” strain in ventilator induced lung injury. Quantifying work of breathing, though, has its own unique challenges. The work of breathing is a valuable yardstick for understanding increasing lung elastance. This review will discuss the role of high flow nasal cannula oxygenation in mitigating respiratory distress in SARS-COV2 pneumonia and will explore the indices that can aid in the timely recognition of failure of non-invasive respiratory support modalities and escalation to mechanical ventilation. The trajectory of recommendations on customary intubation practices has undertaken significant paradigm shifts. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.Review Challenges and controversies in COVID-19 respiratory failureĬOVID-19 pneumonia presents distinctive questions and challenges traditional conventions of management of respiratory failure. The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. Our Data: Information on is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act). The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. Participating providers have signed an agreement to accept assignment for all Medicare-covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure.
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