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COVID-19 患者中使用呼气末正压:重新考虑形态与生理之间关系的时候到了。

The use of positive end expiratory pressure in patients affected by COVID-19: Time to reconsider the relation between morphology and physiology.

机构信息

Hedenstierna Laboratory, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Central Intensive Care Unit, Department of Anesthesia, Operation and Intensive Care, Uppsala University Hospital, Uppsala, Sweden.

Hedenstierna Laboratory, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Central Intensive Care Unit, Department of Anesthesia, Operation and Intensive Care, Uppsala University Hospital, Uppsala, Sweden.

出版信息

Best Pract Res Clin Anaesthesiol. 2020 Sep;34(3):561-567. doi: 10.1016/j.bpa.2020.07.007. Epub 2020 Jul 18.

Abstract

Coronavirus disease 2019 (COVID-19) is a new disease with different phases that can be catastrophic for subpopulations of patients with cardiovascular and pulmonary disease states at baseline. Appreciation for these different phases and treatment modalities, including manipulation of ventilatory settings and therapeutics, has made it a less lethal disease than when it emerged earlier this year. Different aspects of the disease are still largely unknown. However, laboratory investigation and clinical course of the COVID-19 show that this new disease is not a typical acute respiratory distress syndrome process, especially during the first phase. For this reason, the best strategy to be applied is to treat differently the single phases and to support the single functions of the failing organs as they appear.

摘要

2019 年冠状病毒病(COVID-19)是一种具有不同阶段的新疾病,对于基础心肺疾病患者亚群来说可能是灾难性的。对这些不同阶段和治疗方式的认识,包括对通气设置和治疗方法的调整,使 COVID-19 成为一种比今年早些时候危害性更小的疾病。然而,该疾病的许多方面仍知之甚少。但是,COVID-19 的实验室研究和临床过程表明,这种新疾病并非典型的急性呼吸窘迫综合征过程,尤其是在第一阶段。因此,应用的最佳策略是针对不同阶段进行差异化治疗,并在单个衰竭器官出现时支持其单一功能。

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