COVID-19 疫情期间的插管与通气：武汉的经验。
Intubation and Ventilation amid the COVID-19 Outbreak: Wuhan's Experience.
机构信息
From the Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (L.M., R.D.) the Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China (H.Q.) the Department of Anesthesiology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China (L.W.) the Departments of Critical Care Medicine (Y.A., L.Z.) Anesthesiology (Q.G.) Respiratory Medicine (J.M.), Xiangya Hospital, Central South University, Changsha, Hunan Province, China the Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China (Z.X.) the Department of Anesthesiology, Wake Forest University, Winston-Salem, North Carolina (C.T.) the Department of Anesthesiology and Pain Medicine, University of California Davis, Sacramento, California (H.L.) the Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, Tongji University School of Medicine, Shanghai, China (L.X.).
出版信息
Anesthesiology. 2020 Jun;132(6):1317-1332. doi: 10.1097/ALN.0000000000003296.
The COVID-19 outbreak has led to 80,409 diagnosed cases and 3,012 deaths in mainland China based on the data released on March 4, 2020. Approximately 3.2% of patients with COVID-19 required intubation and invasive ventilation at some point in the disease course. Providing best practices regarding intubation and ventilation for an overwhelming number of patients with COVID-19 amid an enhanced risk of cross-infection is a daunting undertaking. The authors presented the experience of caring for the critically ill patients with COVID-19 in Wuhan. It is extremely important to follow strict self-protection precautions. Timely, but not premature, intubation is crucial to counter a progressively enlarging oxygen debt despite high-flow oxygen therapy and bilevel positive airway pressure ventilation. Thorough preparation, satisfactory preoxygenation, modified rapid sequence induction, and rapid intubation using a video laryngoscope are widely used intubation strategies in Wuhan. Lung-protective ventilation, prone position ventilation, and adequate sedation and analgesia are essential components of ventilation management.
根据 2020 年 3 月 4 日发布的数据，中国大陆新冠肺炎确诊病例 80409 例，死亡 3012 例。大约有 3.2%的 COVID-19 患者在疾病过程中需要插管和有创通气。在感染风险增加的情况下，为数众多的 COVID-19 患者提供最佳的插管和通气实践是一项艰巨的任务。作者介绍了在武汉照顾 COVID-19 重症患者的经验。严格遵守自我保护措施至关重要。尽管进行高流量氧疗和双相正压通气，但为了对抗不断增大的氧债，及时而非过早地插管至关重要。在武汉，广泛使用的插管策略包括彻底的准备、满意的预氧合、改良的快速序贯诱导以及使用视频喉镜进行快速插管。肺保护性通气、俯卧位通气以及充分的镇静和镇痛是通气管理的重要组成部分。
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