Jiang Yichun, Chen Jun, Cen Fulan, Li Xu, Song Zhi, Peng Mian, Liu Xueyan
Department of Critical Care Medicine, Shenzhen People's Hospital, Shenzhen, China.
Department of Critical Care Medicine, Shenzhen People's Hospital, Shenzhen, China; School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing, China.
Am J Emerg Med. 2020 Aug;38(8):1698.e1-1698.e4. doi: 10.1016/j.ajem.2020.04.055. Epub 2020 Apr 30.
The clinical therapy for severe 2019 coronavirus disease (i.e., COVID-19) sufferers is relatively challenging. Herein, the processes involving salvage of a critical COVID-19 patient were retrospectively analyzed. The condition of an obese female critical COVID-19 sufferer progressively worsened in the initial period after admission. According to her symptoms and examination reports, endotracheal intubation and mechanical ventilation were timely conducted and meanwhile high-dose sedatives and analgesics were administrated. In the later therapeutic phase, however, sedative and analgesic dosages were gradually reduced, and psychological and rehabilitative therapies were conducted, concomitantly with enhancement of airway care to facilitate sputum expectoration. Eventually, the endotracheal tube was feasibly removed after intubation for 18 days and subsequently replaced with noninvasive ventilation and a high-flow nasal cannula oxygen therapy. Intensive airway care alongside psychological and rehabilitative therapies can shorten the mechanical ventilation time and improve the prognosis of COVID-19 sufferers.
2019年冠状病毒病（即COVID-19）重症患者的临床治疗颇具挑战性。在此，对一名危重型COVID-19患者的救治过程进行回顾性分析。一名肥胖女性危重型COVID-19患者入院初期病情逐渐恶化。根据其症状和检查报告，及时进行了气管插管和机械通气，同时给予大剂量镇静剂和镇痛药。然而，在后期治疗阶段，逐渐减少镇静剂和镇痛药的剂量，并进行心理和康复治疗，同时加强气道护理以促进痰液咳出。最终，气管插管18天后成功拔除，随后改用无创通气和高流量鼻导管吸氧治疗。强化气道护理以及心理和康复治疗可缩短机械通气时间，改善COVID-19患者的预后。
