Lutz Noémie, Wagenheim Cédric, de Zan Carole, Anderhueb Manon, Lefort Hugues
Hôpital d'instruction des armées Legouest, structure des urgences, 27 avenue de Plantières, BP 90001, 57077 Metz cedex 3, France.
Hôpital d'instruction des armées Legouest, structure des urgences, 27 avenue de Plantières, BP 90001, 57077 Metz cedex 3, France.
Soins. 2020 Oct;65(849):38-42. doi: 10.1016/S0038-0814(20)30242-5.
COVID-19 was initially considered exclusively as a respiratory disease. It now appears that it is also a systemic disease with vascular inflammation and thromboses. In the most severe forms, these plurifactorial pulmonary lesions are responsible for acute respiratory distress syndrome. The treatment of this syndrome, which causes hypoxemia, requires urgent oxygen therapy. While initial recommendations favoured the rapid use of intubation and mechanical ventilation, experience seems to confirm that it must be delayed as long as possible, in favour of non-invasive ventilation, less aggressive for the patient.
新冠肺炎最初仅被视为一种呼吸道疾病。现在看来,它也是一种伴有血管炎症和血栓形成的全身性疾病。在最严重的情况下,这些多因素导致的肺部病变会引发急性呼吸窘迫综合征。对这种导致低氧血症的综合征的治疗需要紧急氧疗。虽然最初的建议倾向于迅速进行插管和机械通气,但经验似乎证实,只要有可能,就必须推迟,而采用对患者侵袭性较小的无创通气。