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关于 COVID-19 机械通气患者的重症监护病房管理,你需要知道的十件事。

Ten things you need to know about intensive care unit management of mechanically ventilated patients with COVID-19.

机构信息

Policlinico San Martino, IRCCS per l'Oncologia e Neuroscienze, Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università degli Studi di Genova, Genoa, Italy.

Dipartimento di Anestesia e Rianimazione, Policlinico San Martino, IRCCS per l'Oncologia e le Neuroscienze, Genoa, Italy.

出版信息

Expert Rev Respir Med. 2021 Oct;15(10):1293-1302. doi: 10.1080/17476348.2021.1906226. Epub 2021 Apr 6.

Abstract

The ongoing pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has posed important challenges for clinicians and health-care systems worldwide. The aim of this manuscript is to provide brief guidance for intensive care unit management of mechanically ventilated patients with COVID-19 based on the literature and our direct experience with this population. PubMed, EBSCO, and the Cochrane Library were searched up until 15th of January 2021 for relevant literature. Initially, the respiratory management of COVID-19 relied on the general therapeutic principles for acute respiratory distress syndrome; however, recent findings have suggested that the pathophysiology of hypoxemia in patients with COVID-19 presents specific features and changes over time. Several therapies, including antiviral and anti-inflammatory agents, have been proposed recently. The optimal intensive care unit management of patients with COVID-19 remains unclear; therefore, ongoing and future clinical trials are warranted to clarify the optimal strategies to adopt in this cohort of patients.

摘要

由严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)引起的持续大流行,给全球临床医生和医疗保健系统带来了重大挑战。本手稿的目的是根据文献并结合我们对该人群的直接经验,为 COVID-19 机械通气患者的重症监护病房管理提供简要指导。检索了 PubMed、EBSCO 和 Cochrane Library 截至 2021 年 1 月 15 日的相关文献。最初,COVID-19 的呼吸管理依赖于急性呼吸窘迫综合征的一般治疗原则;然而,最近的研究结果表明,COVID-19 患者低氧血症的病理生理学具有特定的特征,并随时间发生变化。最近提出了几种治疗方法,包括抗病毒和抗炎药物。COVID-19 患者的最佳重症监护病房管理仍不清楚;因此,需要进行正在进行和未来的临床试验,以明确在这一组患者中采用的最佳策略。

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