Department of Medicine, McMaster University, Hamilton, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada.
Crit Care Med. 2020 Jun;48(6):e440-e469. doi: 10.1097/CCM.0000000000004363.
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed.
We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations.
The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which four are best practice statements, nine are strong recommendations, and 35 are weak recommendations. No recommendation was provided for six questions. The topics were: 1) infection control, 2) laboratory diagnosis and specimens, 3) hemodynamic support, 4) ventilatory support, and 5) COVID-19 therapy.
The Surviving Sepsis Campaign COVID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19. When available, we will provide new evidence in further releases of these guidelines.
新型严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）是一种迅速传播的疾病——2019 年冠状病毒病（COVID-19）的病原体，影响了全球成千上万的人。迫切需要为照顾这些患者中病情最严重的临床医生提供指导。
我们组建了一个由来自 12 个国家的 36 名专家组成的小组。所有小组成员都完成了世界卫生组织利益冲突披露表。该小组提出了 53 个与 ICU 中 COVID-19 管理相关的问题。我们在 ICU 中患有 COVID-19 的危重症患者管理方面的文献中查找了直接和间接证据。我们确定了与支持性护理相关的大多数问题的相关和最新系统评价。我们使用评估、制定与评价分级（GRADE）方法评估证据的确定性，然后根据获益与危害、资源与成本、公平性和可行性之间的平衡来制定建议。建议要么是强推荐，要么是弱推荐，要么是最佳实践推荐。
拯救脓毒症运动 COVID-19 小组发布了 54 条声明，其中 4 条是最佳实践声明，9 条是强推荐，35 条是弱推荐。有 6 个问题没有提供建议。这些主题是：1）感染控制；2）实验室诊断和标本；3）血流动力学支持；4）通气支持；5）COVID-19 治疗。
拯救脓毒症运动 COVID-19 小组发布了一些建议，以帮助支持护理 ICU 中患有 COVID-19 的危重症患者的医护人员。在有新证据时，我们将在这些指南的进一步版本中提供新证据。
