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危重症护理中新冠病毒病管理的演变:来自英国一家医院的综述与展望

Evolution of COVID-19 management in critical care: review and perspective from a hospital in the United Kingdom.

作者信息

Jha Avinash Kumar, Kulkarni Sudhindra Gurunath

机构信息

Critical Care Unit, Royal Preston Hospital, Preston, UK.

出版信息

Acute Crit Care. 2021 Feb;36(1):1-14. doi: 10.4266/acc.2020.00864. Epub 2021 Feb 26.

Abstract

The unexpected emergence and spread of coronavirus disease 2019 (COVID-19) has been pandemic, with long-lasting effects, and unfortunately, it does not seem to have ended. Integrating advanced planning, strong teamwork, and clinical management have been both essential and rewarding during this time. Understanding the new concepts of this novel disease and accommodating them into clinical practice is an ongoing process, ultimately leading to advanced and highly specific treatment modalities. We conducted a literature review through PubMed, Europe PMC, Scopus, and Google Scholar to incorporate the most updated therapeutic principles. This article provides a concise and panoramic view of the cohort of critically ill patients admitted to the intensive care unit. We conclude that COVID-19 management includes low tidal volume ventilation, early proning, steroids, and a high suspicion for secondary bacterial/fungal infections. Lung ultrasound is emerging as a promising tool in assessing the clinical response. Managing non-clinical factors such as staff burnout, communication/consent issues, and socio-emotional well-being is equally important.

摘要

2019年冠状病毒病(COVID-19)意外出现并传播,已成为大流行病,产生了持久影响,不幸的是,它似乎尚未结束。在此期间,整合先进规划、强大团队合作和临床管理既至关重要又富有成效。理解这种新型疾病的新概念并将其纳入临床实践是一个持续的过程,最终会带来先进且高度特异性的治疗方式。我们通过PubMed、欧洲PMC、Scopus和谷歌学术进行了文献综述,以纳入最新的治疗原则。本文简要而全面地介绍了入住重症监护病房的重症患者群体。我们得出结论,COVID-19的管理包括低潮气量通气、早期俯卧位、使用类固醇,以及高度怀疑继发性细菌/真菌感染。肺部超声正成为评估临床反应的一种有前景的工具。管理诸如工作人员倦怠、沟通/同意问题以及社会情感健康等非临床因素同样重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0048/7940099/b1ee67c320e9/acc-2020-00864f1.jpg

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