My name is Jeff Guy and this is ICRounds.

Welcome back to ICRounds.

We're going to talk today about the management of the hypoxic patient with respiratory failure, specifically ARDS.

And the topic is timely given what we're currently facing relative to the COVID pandemic.

Now, I've done a podcast years ago on the basic management of a patient respiratory failure and the different modes of the mechanical ventilator and the like and some podcasts on what peep is and oxygenation.

We'll probably go through some of those fundamental principles today.

But again, there's some 90, some odd podcasts in this catalog.

Go back, take a look, listen to those, and again,

we'll refresh those topics as we go through our talk today.

Initially, the trajectory of the patient in ARDS will go through basically conventional

oxygenation therapy, which would be something like a nasal cannula mask or veni mask, but

what we're seeing recommended here currently relative in around COVID is really no different

than how you would manage potentially any other ARDS patient relative to the oxygenation strategy.

There's these ideas of what's called bridge therapy.

And the idea behind bridge therapy is a modality

oxygenation, kind of in this no man's land between conventional oxygen therapy and my last

ditch efforts before crossed the bridge over to using invasive mechanical ventilation.

There's really two elements in this idea of bridge therapy. There's this idea of non-invasive positive pressure ventilation, and then there's this high flow nasal canula.

Putting a patient on a bridge therapy, you need to be asking yourself the question is what happens if this doesn't work?

What's going to be my next modality?

And typically that's going to be invasively ventilating the patient and inobating them.

Once you set somebody on one of these therapies, one of the key elements of success

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