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新冠病毒(COVID-19):确保我们的医疗设备能够应对挑战。

COVID-19: ensuring our medical equipment can meet the challenge.

机构信息

Healthcare Directorate Unit, Veneto Institute of Oncology IRCCS , Padova, Italy.

Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Biostatistics, Epidemiology and Public Health, University of Padova , Padova, Italy.

出版信息

Expert Rev Med Devices. 2020 Jun;17(6):483-489. doi: 10.1080/17434440.2020.1772757. Epub 2020 Jun 13.

Abstract

To predict the spread of coronavirus disease globally and consequently prepare the hospital facilities with the required technology is a challenge. The availability of essential medical equipment to support patients affected by Covid-19 is globally limited. Areas covered This perspective gives a technical view of the pandemic focusing on the main actions taken by regulatory agencies to cope with the shortage of devices. The risk/benefit assessment and the main infection control policies in the clinical practices are also looked at. Expert opinion Regulatory agencies have amended their medical devices directives to address the pandemic, but each in a different way. In this exceptional situation scientist and technology experts in collaboration with medical specialists should work together to re-assess the risk analysis on medical equipment management and their use and re-use in this context with the aim to improve global health care Every effort must be made to provide the necessary devices at least with the minimum acceptable performances for Covid-19 patients while maintaining a high standard of safety for users. The aim of the present manuscript is to highlight the technical challenges in order to prevent, through targeted actions, operating standards from falling below the standards of care due to a lack of medical devices. Abbreviations AKI: acute Kidney Injury; ARGMD: Australian Regulatory Guidelines for Medical Devices; Covid-19: Coronavirus disease; FDA: Food and Drug Administration; ECMO: Extracorporeal Membrane Oxygenation; EU: European Union; ICU: Intensive Care Unit; WHO: World Health Organization; MHRA: Medicines and Healthcare products Regulatory Agency; MDR: Medical Device Regulation; SARI: Severe Acute Respiratory Infection.

摘要

预测冠状病毒病在全球的传播,并相应地为医院配备所需的技术是一项挑战。能够支持新冠病毒患者的基本医疗设备在全球范围内是有限的。涵盖范围本观点从技术角度关注大流行,重点关注监管机构为应对设备短缺而采取的主要行动。还审视了临床实践中的风险/收益评估和主要感染控制政策。专家意见监管机构已经修订了他们的医疗器械指令以应对大流行,但每个机构的方式都不同。在这种特殊情况下,科学家和技术专家应与医学专家合作,共同重新评估医疗设备管理及其在这种情况下的使用和再使用的风险分析,目的是改善全球医疗保健。必须尽一切努力为新冠病毒患者提供必要的设备,至少提供可接受的最低性能,同时为使用者保持高标准的安全性。本手稿的目的是强调技术挑战,以便通过有针对性的行动防止由于缺乏医疗器械而导致操作标准低于护理标准。缩写词 AKI:急性肾损伤;ARGMD:澳大利亚医疗器械监管指南;Covid-19:冠状病毒病;FDA:食品和药物管理局;ECMO:体外膜氧合;欧盟:欧洲联盟;ICU:重症监护室;世卫组织:世界卫生组织;MHRA:药品和医疗保健产品监管机构;MDR:医疗器械法规;SARI:严重急性呼吸道感染。

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