Covid-19 Airway Management and Ventilation Strategy for Critically Ill Older Patients

Preface
Contents
Part I: Epidemiology
	1: Mortality and Prognosis of Older Patients During COVID-19 Pandemic
		1.1 Epidemiological Perspective: A Global View of the Problem
		1.2 Why the Elderly Is at Higher Risk? A Pathophysiological View
		1.3 Prognosis of the COVID-19 Elderly Patient
		References
	2: Elderly Pneumonia COVID-19 Cases: Impact on the Outcome
		2.1 Introduction
		2.2 Acute Complications Associated with COVID-19 Pneumonia in Elderly
		2.3 Elderly Mortality Rate for COVID-19 Disease
		2.4 Conclusion
		References
	3: Incidence of ARF Due to COVID-19 Interstitial Pneumonia
		References
	4: Changing the Demographics in ICU During COVID-19 Pandemic
		4.1 Pre-COVID-19 Epidemy Demographic Aspects in ICU
		4.2 Demographic Aspects During the COVID-19 Outbreak in ICU
		4.3 Comparison between H1N1 and COVID-19 Epidemy
		4.4 Conclusions
		References
Part II: The Diagnosis of COVID ARF in Elderly
	5: Differential Diagnosis of Types of Pneumonia in the Elderly
		5.1 Introduction
		5.2 Aging of the Respiratory System and the Impact of Pneumonia
		5.3 Epidemiology
		5.4 Causes
		5.5 Routes of Transmission
			5.5.1	 Inhalation (Fig. 5.1)
			5.5.2	 Aspiration (Fig. 5.2)
			5.5.3	 Hematogenous Spread (Fig. 5.3)
			5.5.4	 Direct Extension from Adjacent Infected Foci (Fig. 5.4)
		5.6 Clinical Presentation
		5.7 COVID-19 Pneumonia “Phenotypes”
			5.7.1	 L-Phenotype
			5.7.2	 H-Phenotype
		5.8 Risk Stratification
			5.8.1	 CURB-65 (Table 5.3)
			5.8.2	 Pneumonia Severity Index, Also Known as the PORT Score (Fig. 5.5 and Table  5.4)
			5.8.3	 IDSA/ATS CAP Criteria
			5.8.4	 COVID-GRAM Critical Illness Risk Score
			5.8.5	 Brescia-COVID Respiratory Severity Scale (BCRSS)/Algorithm
		5.9 Imaging
		5.10 Laboratory Investigations
		5.11 Microbiologic Diagnosis
		5.12 Viral Aetiology (Fig. 5.9)
		5.13 Viral Pneumoniae Diagnosis: Upper Respiratory Sample Collection
			5.13.1	 Nasopharyngeal Swab/Oropharyngeal (Throat) Swab (Fig. 5.10)
			5.13.2	 Nasal Mid-Turbinate (NMT) Swab, Also Called Deep Nasal Swab
			5.13.3	 Nasopharyngeal Wash/Aspirate or Nasal Wash/Aspirate (Fig. 5.12)
			5.13.4	 Sputum
			5.13.5	 Storage
		References
	6: The Diagnosis of COVID ARF in Elderly: The Radiological Findings in Elderly
		6.1	 Introduction
		6.2	 Radiology of the Normal Aging Lung and COVID-19 Disease
		6.3	 Chest Imaging in Elderly COVID-19 Patients
		6.4	 Imaging of COVID-19 Pneumonia Complications
		6.5	 Conclusion
		References
Part III: The Screening and the Access to ICU
	7: The Screening and the Access to ICU
		7.1 The Recommendations of the Intensive Caring Scientific Societies
			7.1.1	 The Usual Screening and the Access to ICU
			7.1.2	 The Guidelines During COVID-19 Epidemy
		7.2 Conclusion
		References
	8: The Decision-Making Process of Selection in the Clinical Pathway for COVID-19: The Recommendations for Older Patients
		8.1 Introduction
		8.2 The Geriatric Assessment
		8.3 The Decision-Making Process for an Older Patient
		8.4 Conclusive Remarks
		8.5 Recommendations
		References
	9: COVID-19: End-of-Life Care Decision-Making and Preferences in Older People
		9.1 Introduction
		9.2 The Unexpected Scenario of COVID-19 Disease and Older Patients
		9.3 End-of-Life Preferences of Older Patients: Recommendations During the COVID Pandemic
		9.4 Conclusion
		References
Part IV: Management of ARF
	10: The Impact Frailty, Co-morbidity and Ageing of the Respiratory System on the Unfavourable Prognosis of COVID-19
		10.1	 Introduction
		10.2	 Frailty
		10.3	 Multimorbidity
		10.4	 The Ageing Process
		10.5	 Cognitive Disorders and Delirium
		10.6	 Conclusion
		References
	11: The Physiopathology of COVID Acute Respiratory Failure
		References
	12: Escalation Therapy for ARF 
in Elderly Patient
		12.1	 Introduction
		12.2	 Nasal Cannulae
		12.3	 Simple Mask
		12.4	 Non-rebreather Mask
		12.5	 High-Flow Oxygen Cannula (HFOC)
		12.6	 Invasive Mechanical Ventilation (IMV)
		12.7	 Extracorporeal Membrane Oxygenation (ECMO)
		References
	13: Oxygen Therapy: Liberal Versus Conservative in Older Patients with COVID Disease
		13.1	 Introduction
		13.2	 Oxygen Therapy in Critical Conditions
		13.3	 Oxygen Therapy in COVID-19 Disease
		13.4	 Conclusion
		References
	14: The Role of Non-invasive Ventilation
		14.1	 Introduction
		14.2	 Indications of Non-invasive Ventilation (Table 14.1)
		14.3	 Technique
		14.4	 Conclusion
		References
	15: The Invasive Ventilation in Older Patients: The Timing
		References
	16: The Role of ECMO
		16.1	 Background
		16.2	 Indications of ECMO
		16.3	 ECMO Management
		16.4	 ECMO Preparedness
		16.5	 Ethical Issues
		16.6	 Conclusions and Recommendations
		References
	17: The Role of HFNC
		17.1	 Introduction
		17.2	 Rationale Use of HFNC
		17.3	 Usefulness to HFNC Use in COVID Patients
		17.4	 Bio-aerosol Dispersion during HFNC
		17.5	 Self-Proning with High-Flow Nasal Cannula
		17.6	 Conclusion
		References
	18: The Problem of Aerosolization
		18.1	 Introduction
		18.2	 Protective Strategies (Table 18.1)
		18.3	 Conclusion
		References
Part V: The Setting
	19: The Older Patients in Subacute Units
		19.1	 Introduction
		19.2	 General Remarks
		19.3	 Methods
			19.3.1	 Therapeutic Respiratory in Subacute Units for Old Patients
			19.3.2	 Prone Position
			19.3.3	 Drugs
			19.3.4	 Recommendation on Safety and Environments Health for the Prevention of Contagion
		19.4	 Conclusion
		References
	20: The ICU
		20.1	 The ICU
			20.1.1	 Introduction
			20.1.2	 What Is an Intensive Care Unit?
			20.1.3	 Needs of Elderly Patients with SARS-CoV2 at ICU
			20.1.4	 Structural Needs of an ICU Treating COVID-19 Patients
		References
	21: The Admission of Older Patients with COVID-19 in the General Wards
		21.1	 Introduction
		21.2	 The Complexity of Older Patients
		21.3	 The Older with COVID-19 Recognition with a Score
		21.4	 Clinical Evaluation and Risk Factors
		21.5	 Conclusion
		References
	22: The Management of Elderly Patients with COVID Out of the Hospital: The Italian Experience
		22.1	 Introduction
		22.2	 Community Hospital
		22.3	 Nursing Homes or Long-Term Care Facility
		22.4	 The Management of Older People with COVID-19 in Dementia Special Care Unit
		22.5	 The Management at Home: The Role of USCA (Special Care Unit of Continuity of Care)
		22.6	 Conclusive Remarks
		References
Part VI: Conclusion
	23: The Geriatric Perspectives in the Time of COVID-19
		23.1	 Introduction
		23.2	 Ethical Factors
		23.3	 Legal Aspects
		23.4	 The Clinical Context
		23.5	 Conclusion
		References