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2019 冠状病毒病(COVID-19)的重症监护管理:挑战与建议。

Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations.

机构信息

Fast and Chronic Programmes, Alexandra Hospital, National University Health System, Singapore; Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore.

Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China.

出版信息

Lancet Respir Med. 2020 May;8(5):506-517. doi: 10.1016/S2213-2600(20)30161-2. Epub 2020 Apr 6.

Abstract

As coronavirus disease 2019 (COVID-19) spreads across the world, the intensive care unit (ICU) community must prepare for the challenges associated with this pandemic. Streamlining of workflows for rapid diagnosis and isolation, clinical management, and infection prevention will matter not only to patients with COVID-19, but also to health-care workers and other patients who are at risk from nosocomial transmission. Management of acute respiratory failure and haemodynamics is key. ICU practitioners, hospital administrators, governments, and policy makers must prepare for a substantial increase in critical care bed capacity, with a focus not just on infrastructure and supplies, but also on staff management. Critical care triage to allow the rationing of scarce ICU resources might be needed. Researchers must address unanswered questions, including the role of repurposed and experimental therapies. Collaboration at the local, regional, national, and international level offers the best chance of survival for the critically ill.

摘要

随着 2019 年冠状病毒病(COVID-19)在全球范围内的传播,重症监护病房(ICU)必须为应对这一流行病带来的挑战做好准备。简化快速诊断和隔离、临床管理和感染预防的工作流程,不仅对 COVID-19 患者,而且对有医院内传播风险的医护人员和其他患者都很重要。急性呼吸衰竭和血液动力学的管理是关键。重症监护从业者、医院管理人员、政府和决策者必须为重症监护病床容量的大幅增加做好准备,重点不仅是基础设施和用品,还有员工管理。可能需要进行重症监护分诊,以合理分配稀缺的 ICU 资源。研究人员必须解决尚未解决的问题,包括重新利用和实验性治疗的作用。地方、区域、国家和国际各级的合作为重症患者的生存提供了最佳机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ca0/7198848/2f263e99cda6/gr1_lrg.jpg

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