Non-invasive Ventilation in Covid-19

COVID-19 pandemic represented a challenge not only for the clinical management, but also for the allocation of the resources. In fact, the enormous amount of patients requiring respiratory support and advanced care often overwhelmed the availability of a sufficient number of ventilatory support devices and intensive care beds. COVID-19 presentation can extremely vary from asymptomatic forms to severe ARDS and it is important to carefully choose the most adequate ventilation. In this scenario, non-invasive ventilation (NIV) has frequently been adopted as first-line therapy, particularly during the early phase of the pandemic in those situations characterized by the lack of intensive care facilities. The routine use of NIV in COVID-19 is still controversial: it showed to be effective when wisely used, i.e., monitoring the evolution of clinical and instrumental conditions of the patients and early switching to tracheal intubation if no improvements are recorded or signs of respiratory distress and excessive respiratory work arise.