Koç University School of Nursing, Istanbul, Turkey.
Koç University Hospital, Adult Intensive Care Unit, Istanbul, Turkey.
Nurs Crit Care. 2022 Sep;27(5):628-634. doi: 10.1111/nicc.12602. Epub 2021 Feb 10.
This paper reports the presentation and management of an older female patient who was diagnosed with Coronavirus disease (COVID-19) and discharged from an intensive care unit (ICU) after prolonged hospitalization. The patient's COVID-19 test was negative; therefore, she was monitored in the COVID-19 general clinic with normal levels of oxygen saturation (SpO ). The patient had been taking Plaquenil for rheumatoid arthritis for a long time. Azithromycin was administered first, and then, the treatment continued with favipiravir according to the national treatment protocol in Turkey. On the third day in the COVID-19 general clinic, she was transferred to the ICU because of decreased saturation levels. Owing to worsening respiratory status and SpO <70%, the patient was intubated on the sixth day in the ICU, and every day, she was nursed in a prone position for >16 hours. We believe that the treatment and care activities under qualified and effective nursing care, such as providing appropriate respiratory support at the right time, early initiation and maintenance of anticoagulant therapy, long-term prone positioning, maintaining sufficient fluid resuscitation, and early commencement of balanced enteral nutrition, contributed to the successful discharge of the patient from the ICU. The patient was finally extubated on the 23rd day. Respiratory support was continued with oxygen administered at 2 lt/min through a nasal canula with SpO at 94%. We believe that by combining all these factors, the patient's results improved. She was discharged from the ICU after 25 days without any organ dysfunction. During the 25 days of care in the ICU, infectious disease protection and isolation rules were strictly adhered to, and personal protective equipment was worn.
本文报告了一位老年女性患者的就诊和治疗经过，该患者被诊断患有冠状病毒病（COVID-19），在长时间住院后从重症监护病房（ICU）出院。患者的 COVID-19 检测结果为阴性；因此，她在 COVID-19 普通诊所接受监测，氧饱和度（SpO ）正常。该患者因类风湿性关节炎长期服用羟氯喹。首先给予阿奇霉素治疗，然后根据土耳其国家治疗方案继续使用法匹拉韦治疗。在 COVID-19 普通诊所的第三天，由于饱和度水平下降，她被转至 ICU。由于呼吸状况恶化和 SpO <70%，患者在 ICU 的第六天被插管，每天在 ICU 中接受超过 16 小时的俯卧位护理。我们认为，在合格且有效的护理下进行的治疗和护理活动，如在适当的时机提供适当的呼吸支持、早期开始并维持抗凝治疗、长期俯卧位、保持充足的液体复苏以及尽早开始均衡的肠内营养，有助于患者从 ICU 成功出院。患者最终在第 23 天拔管。通过鼻导管以 2 l/min 的流量给予氧气，SpO 为 94%，继续进行呼吸支持。我们认为，通过综合所有这些因素，患者的病情得到了改善。她在没有任何器官功能障碍的情况下从 ICU 出院。在 ICU 护理的 25 天中，严格遵守传染病防护和隔离规则，并佩戴个人防护设备。
