Li H C, Ma J, Zhang H, Cheng Y, Wang X, Hu Z W, Li N, Deng X R, Zhang Y, Zheng X Z, Yang F, Weng H Y, Dong J P, Liu J W, Wang Y Y, Liu X M
Division of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China.
Division of Critical Care Medicine, Peking University First Hospital, Beijing 100034, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2020 May 12;43(5):396-400. doi: 10.3760/cma.j.cn112147-20200312-00320.
Severe and critical coronavirus pneumonia 2019 (COVID-19) often occurs in elder patients with multiple comorbidities, and severe hypoxemia events constitute a key factor for the deterioration of some cases. The critical type of COVID-19 could progress into acute respiratory distress syndrome and multi-organ dysfunction, which are the major causes of death. Early non-invasive ventilation (NIV) treatment of possible pathophysiological abnormalities is helpful to improve prognosis. Close monitoring of oxygenation, reducing patients' oxygen consumption, active psychological intervention, and rapid handling of severe hypoxemia events are the key factors for successful NIV treatment. In addition, active adjuvant therapies such as correcting coagulation dysfunction, providing proper nutritional support, accurate volume control, and safe individualized blood glucose monitoring are of great significance.
2019年新型冠状病毒肺炎（COVID-19）重症及危重症常发生于合并多种基础疾病的老年患者，严重低氧血症事件是部分病例病情恶化的关键因素。COVID-19危重型可进展为急性呼吸窘迫综合征和多器官功能障碍，是主要死亡原因。早期对可能存在的病理生理异常进行无创通气（NIV）治疗有助于改善预后。密切监测氧合、降低患者耗氧量、积极心理干预以及迅速处理严重低氧血症事件是NIV治疗成功的关键因素。此外，积极的辅助治疗如纠正凝血功能障碍、提供适当营养支持、精确容量控制以及安全的个体化血糖监测也具有重要意义。
