farmaecFARMAKOEKONOMIKA. Modern Pharmacoeconomics and PharmacoepidemiologyФАРМАКОЭКОНОМИКА. Современная фармакоэкономика и фармакоэпидемиология2070-49092070-4933IRBIS LLC10.17749/2070-4909/farmakoekonomika.2023.174farmaec-800Research ArticleREVIEW ARTICLESОБЗОРНЫЕ ПУБЛИКАЦИИNon-invasive respiratory support in patients with severe community-acquired pneumoniaНеинвазивная вентиляция легких у больных с внебольничными пневмониями тяжелого теченияКоротченкоС. В.KorotchenkoS. V.

Коротченко Светлана Валерьевна – заведующая отделением реанимации и интенсивной терапии Клинического госпиталя; ассистент кафедры хирургических болезней с курсами эндоскопии, анестезиологии и реаниматологии, акушерстваи гинекологии

ул. Новая Ипатовка, д. 3, Москва 127299

ул. 2-я Брестская, д. 5, Москва 123056

Svetlana V. Korotchenko – MD, Head of the Resuscitation and Intensive Therapy Unit;  Assistant Professor, Chair of Surgical Diseases with Courses in Endoscopy, Anesthesiology and Resuscitation, Obstetrics and Gynecology

3 Novaya Ipatovka Str., Moscow 127299

5 Brestskaya Str., Moscow 12305

bre-vis@yandex.ruhttps://orcid.org/0000-0002-0459-0488КорабельниковД. И.KorabelnikovD. I.

Корабельников Даниил Иванович – к.м.н., профессор кафедры внутренних болезней, заведующий кафедрой профилактической медицины, ректор

ул. 2-я Брестская, д. 5, Москва 123056

Scopus Author ID: 7801382184

Daniil I. Korabelnikov – MD, PhD, Professor, Chair of Internal Diseases, Chief of Chair of Preventive Medicine, Rector

Scopus Author ID: 7801382184

5 Brestskaya Str., Moscow 12305

Федеральное казенное учреждение здравоохранения «Медико-санитарная часть Министерства внутренних дел Российской Федерации по г. Москве»; Автономная некоммерческая организация дополнительного профессионального образования «Московский медико-социальный институт им. Ф.П. Гааза»РоссияClinical Hospital, Medical Sanitary Unit of the Ministry of Internal Affairs of Russia in Moscow; Moscow Haass Medical Social InstituteRussian FederationАвтономная некоммерческая организация дополнительного профессионального образования «Московский медико-социальный институт им. Ф.П. Гааза»РоссияMoscow Haass Medical Social InstituteRussian Federation202321042023161134–143Copyright © Korotchenko S.V., Korabelnikov D.I., 20232023Коротченко С.В., Корабельников Д.И.Korotchenko S.V., Korabelnikov D.I.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pharmacoeconomics.ru/jour/article/view/800

Acute respiratory failure (ARF) is the leading cause of death in hospitalized patients with severe forms of COVID-19. At the beginning of COVID-19 pandemic the starting respiratory protocol suggested early use of intubation and artificial lung ventilation (ALV) in patients with severe pneumonia complicated by ARF. However, after the analysis of the published studies it was noted that the pathophysiology of the development of ARF in COVID-19 had features that determine the atypical clinical pattern – “silent hypoxemia”. This leads to the late onset of respiratory support (RS) and, as a result, to the lower effectiveness of non-invasive RS methods. This article discusses the creation of an algorithm for the early use of various non-invasive RS methods in patients with COVID-19 complicated by ARF, that will decrease the frequency of hospitalization to the Intensive care units, tracheal intubation and ALV, reduce the duration of treatment and improve prognosis.

Острая дыхательная недостаточность (ОДН) является ведущей причиной смерти пациентов с тяжелыми формами COVID-19, госпитализированных в стационары. В первые месяцы пандемии при тяжелой пневмонии, осложненной ОДН, стартовый респираторный протокол предполагал раннее использование у пациентов интубации и искусственной вентиляции легких (ИВЛ). Однако при анализе данных опубликованных исследований отмечено, что патофизиология развития ОДН при COVID-19 имеет особенности, которые обусловливают атипичность клинической картины («тихая гипоксемия»). Это приводит к позднему началу респираторной поддержки (РП) и, как следствие, меньшей эффективности неинвазивных методов РП. В статье рассматривается вопрос создания алгоритма раннего применения различных методов неинвазивной РП у пациентов с COVID-19, осложненным развитием ОДН, что позволит снизить частоту переводов в отделение реанимации, интубации трахеи и перевода на ИВЛ, сократить длительность лечения в целом и улучшить прогноз.

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The authors declare that there are no conflicts of interest present.