Department of Anesthesiology, Wuhan No.1 Hospital, Zhongshan Avenue 215#, Wuhan, 430022, Hubei, China.
J Anesth. 2020 Aug;34(4):599-606. doi: 10.1007/s00540-020-02778-8. Epub 2020 Apr 17.
SARS-CoV-2 pandemic is announced and it is very important to share our experience to the critical care community in the early stage. Urgent intubation team was organized by anesthesiologists and was dispatched upon request. We have retrospectively reviewed medical charts of 20 critically ill patients with Covid-19 pneumonia who required tracheal intubation from February 17 to March 19 in Wuhan No.1 hospital, China. We collected their demographics, vital signs, blood gas analysis before and after tracheal intubation, and 7-day outcome after tracheal intubation. Out of 20 patients, 90% were over 60 years old and 15 were with at least one comorbidity. All meet the indication for tracheal intubation announced by treatment expert group. We had successfully intubated all patients using personal protective equipment without circulatory collapse during tracheal intubation. During the observational period, none of 17 anesthesiologists were infected. Although intubation improved SPO, reduced PaCO and blood lactate, seven of 20 patients died within 7-days after tracheal intubation. Non-survivors showed significantly lower SPO and higher PaCO and blood lactate compared to survivors. For those who are anticipated to deteriorate severe pneumonia with poor prognosis, earlier respiratory support with tracheal intubation may be advised to improve outcome.
SARS-CoV-2 大流行已经宣布，在早期向重症监护社区分享我们的经验非常重要。由麻醉师组织的紧急插管团队应要求派遣。我们回顾性分析了 2 月 17 日至 3 月 19 日期间在中国武汉第一医院因 COVID-19 肺炎需要气管插管的 20 名危重症患者的病历。我们收集了他们的人口统计学资料、生命体征、气管插管前后的血气分析结果，以及气管插管后 7 天的结果。20 名患者中，90%的患者年龄超过 60 岁，15 名患者至少有一种合并症。所有患者均符合治疗专家组公布的气管插管适应证。我们使用个人防护设备成功地为所有患者进行了插管，在插管过程中没有发生循环衰竭。在观察期间，没有 17 名麻醉师感染。虽然插管改善了 SpO2，降低了 PaCO 和血乳酸，但 20 名患者中有 7 人在气管插管后 7 天内死亡。与幸存者相比，非幸存者的 SpO2 明显较低，PaCO 和血乳酸较高。对于那些预计病情严重恶化且预后不良的肺炎患者，建议尽早进行气管插管等呼吸支持，以改善预后。
