Clinical Practice Guidelines on the Management of Hypoxic COVID-19 Patients (SCCM, 2020)



Clinical practice guidelines on the management of hypoxic COVID-19 patients have been released by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine.

Hypoxic Patients With COVID-19


If there is an indication for endotracheal intubation, do the following:
  • Perform the intubation.
  • Ensure an airway expert performs the intubation.
  • Use N-95/FFP-2 or equivalent respirator masks and other personal protective equipment and infection control precautions.
  • Minimize staff presence in the room.
  • Consider using videolaryngoscopy if available
If endotracheal intubation is not indicated and the patient is tolerating supplemental oxygen, do the following:
  • Closely monitor the patient for worsening.
  • Target peripheral capillary oxygen saturation (SpO2) at 92-96%.
  • Ensure appropriate infection control precautions are in place.
  • Do not delay endotracheal intubation should the patient’s condition worsen.
  • If endotracheal intubation is not indicated and the patient is not tolerating supplemental oxygen, consider using high-flow nasal cannula. If this is tolerated, do the following:
  • Closely monitor the patient for worsening.
  • Target SpO2 at 92-96%.
  • Ensure appropriate infection control precautions are in place.
  • Do not delay endotracheal intubation should the patient’s condition worsen.
  • If endotracheal intubation is not indicated, the patient is not tolerating supplemental oxygen, and the patient is not tolerating high-flow nasal cannula (or it is not available), do the following:
  • Consider noninvasive positive-pressure ventilation.
  • Closely monitor the patient at short intervals.
  • Do not delay endotracheal intubation should the patient’s condition worsen.

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