Division of Pulmonary, Critical Care, and Sleep Medicine, Prisma Health USC Medical Group, Columbia, South Carolina, USA.
Department of Internal Medicine, Prisma Health USC Medical Group, Columbia, South Carolina, USA.
J Ultrasound Med. 2021 Sep;40(9):1749-1761. doi: 10.1002/jum.15566. Epub 2020 Nov 11.
Since the advent of SARS-CoV-2, the virus that causes COVID-19, clinicians have had to modify how they provide high-value care while mitigating the risk of viral spread. Routine imaging studies have been discouraged due to elevated transmission risk. Patients who have been diagnosed with COVID-19 often have a protracted hospital course with progression of disease. Given the need for close follow-up of patients, we recommend the use of ultrasonography, particularly point-of-care ultrasound (POCUS), to manage patients with COVID-19 through their entire ICU course. POCUS will allow a clinician to evaluate and monitor cardiac and pulmonary function, as well as evaluate for thromboembolic disease, place an endotracheal tube, confirm central venous catheter placement, and rule out a pneumothorax. If a patient improves sufficiently to perform weaning trials, POCUS can also help evaluate readiness for ventilator liberation.
自导致 COVID-19 的 SARS-CoV-2 病毒出现以来，临床医生不得不改变提供高价值医疗的方式，同时降低病毒传播的风险。由于传播风险增加，常规影像学检查已不被鼓励。已被诊断患有 COVID-19 的患者通常会有一个疾病进展的延长住院过程。鉴于需要密切随访患者，我们建议使用超声检查，特别是即时护理超声（POCUS），通过整个 ICU 治疗过程来管理 COVID-19 患者。POCUS 可让临床医生评估和监测心脏和肺功能，以及评估血栓栓塞性疾病、放置气管内导管、确认中心静脉导管位置和排除气胸。如果患者恢复得足以进行脱机试验，POCUS 还可以帮助评估是否准备好进行呼吸机撤离。
