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COVID-19 患者的呼吸支持(非重症监护病房)。法国呼吸疾病学会呼吸支持和慢性护理组的立场文件。

Respiratory support in patients with COVID-19 (outside intensive care unit). A position paper of the Respiratory Support and Chronic Care Group of the French Society of Respiratory Diseases.

机构信息

Service de Pneumologie et Soins Intensifs Respiratoires, Centre Hospitalier Universitaire de Dijon, 14, rue Gaffarel, 21000 Dijon, France.

Service de Pneumologie, Médecine Intensive et Réanimation (Département R3S, Sorbonne Université, INSERM UMRS 1158 Neurophysiologie respiratoire, expérimentale et clinique, Groupe Hospitalier Universitaire AP-HP Sorbonne Université, AP-HP site Pitié-Salpêtrière, Paris, France.

出版信息

Respir Med Res. 2020 Nov;78:100768. doi: 10.1016/j.resmer.2020.100768. Epub 2020 May 27.

DOI:10.1016/j.resmer.2020.100768
PMID:32707480
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7255256/
Abstract

With first cases noted towards the end of 2019 in China, COVID-19 infection was rapidly become a devastating pandemic. Even if most patients present with a mild to moderate form of the disease, the estimated prevalence of COVID-19-related severe acute respiratory failure (ARF) is 15-20% and 2-12% needed intubation and mechanical ventilation. In addition to mechanical ventilation some other techniques of respiratory support could be used in some forms of COVID-19 related ARF. This position paper of the Respiratory Support and Chronic Care Group of the French Society of Respiratory Diseases is intended to help respiratory clinicians involved in care of COVID-19 pandemic in the rational use of non-invasive techniques such as oxygen therapy, CPAP, non-invasive ventilation and high flow oxygen therapy in managing patients outside intensive care unit (ICU). The aims are: (1) to focus both on the place of each technique and in describing practical tips (types of devices and circuit assemblies) aimed to limit the risk of caregivers when using those techniques at high risk spreading of viral particles; (2) to propose a step-by-step strategy to manage ARF outside ICU.

摘要

自 2019 年底在中国首次发现病例以来,COVID-19 感染迅速成为一场毁灭性的大流行。尽管大多数患者表现为轻度至中度疾病,但 COVID-19 相关严重急性呼吸衰竭(ARF)的估计患病率为 15-20%,需要插管和机械通气的比例为 2-12%。除了机械通气外,一些其他呼吸支持技术也可以用于某些形式的 COVID-19 相关 ARF。本法国呼吸疾病学会呼吸支持和慢性护理小组的立场文件旨在帮助参与 COVID-19 大流行护理的呼吸临床医生合理使用非侵入性技术,如氧疗、CPAP、无创通气和高流量氧疗,以管理重症监护室外(ICU)的患者。目的是:(1)既要关注每种技术的位置,又要描述实用技巧(设备类型和回路组件),旨在限制在高风险传播病毒颗粒的情况下使用这些技术时护理人员的风险;(2)提出一种在 ICU 外管理 ARF 的分步策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f65/7255256/76b5c6e43fe3/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f65/7255256/a9d215f2c240/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f65/7255256/76b5c6e43fe3/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f65/7255256/a9d215f2c240/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f65/7255256/76b5c6e43fe3/gr4.jpg

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