How coronavirus changed the way we support people with respiratory disease

With clinical opinion changing so quickly, it's worth reflecting on how and why this has happened - particularly as the scientific evidence to back up this change is lagging behind clinical practice

As the second wave of the coronavirus pandemic hits hospitals, the hiss and bubble of advanced respiratory support is an increasingly familiar sound on medical wards. This is because some patients who become severely unwell with COVID-19 suffer from respiratory failure and so require breathing support.

This support can be both “invasive”, where a ventilator delivers air to the patient via a tube inserted into the windpipe, or “non-invasive”, where patients are assisted using devices that remain outside the body. Non-invasive techniques are not new, but the pandemic has transformed how they are used. Previously not in routine