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成人 COVID-19 相关急性呼吸窘迫综合征患者镇痛、镇静和谵妄管理的共识。

Consensus for the management of analgesia, sedation and delirium in adults with COVID-19-associated acute respiratory distress syndrome.

机构信息

Hospital General de Agudos José María Penna - Buenos Aires, Argentina.

Ministerio de Salud de la Nación Argentina - Buenos Aires, Argentina.

出版信息

Rev Bras Ter Intensiva. 2021 Jan-Mar;33(1):48-67. doi: 10.5935/0103-507X.20210005.

DOI:10.5935/0103-507X.20210005
PMID:33886853
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8075332/
Abstract

OBJECTIVE

To propose agile strategies for a comprehensive approach to analgesia, sedation, delirium, early mobility and family engagement for patients with COVID-19-associated acute respiratory distress syndrome, considering the high risk of infection among health workers, the humanitarian treatment that we must provide to patients and the inclusion of patients' families, in a context lacking specific therapeutic strategies against the virus globally available to date and a potential lack of health resources.

METHODS

A nonsystematic review of the scientific evidence in the main bibliographic databases was carried out, together with national and international clinical experience and judgment. Finally, a consensus of recommendations was made among the members of the Committee for Analgesia, Sedation and Delirium of the Sociedad Argentina de Terapia Intensiva.

RESULTS

Recommendations were agreed upon, and tools were developed to ensure a comprehensive approach to analgesia, sedation, delirium, early mobility and family engagement for adult patients with acute respiratory distress syndrome due to COVID-19.

DISCUSSION

Given the new order generated in intensive therapies due to the advancing COVID-19 pandemic, we propose to not leave aside the usual good practices but to adapt them to the particular context generated. Our consensus is supported by scientific evidence and national and international experience and will be an attractive consultation tool in intensive therapies.

摘要

目的

考虑到医护人员感染的高风险、我们必须为患者提供的人道主义治疗以及患者家属的参与，针对目前全球尚无针对该病毒的特定治疗策略且医疗资源可能存在潜在短缺的情况，为 COVID-19 相关性急性呼吸窘迫综合征患者提出一种全面的镇痛、镇静、谵妄、早期活动和家属参与的敏捷策略。

方法

对主要文献数据库中的科学证据进行非系统性综述，并结合国家和国际临床经验和判断。最后，阿根廷重症治疗学会镇痛、镇静和谵妄委员会的成员达成了共识。

结果

达成了建议，并制定了工具，以确保对 COVID-19 所致急性呼吸窘迫综合征的成年患者进行全面的镇痛、镇静、谵妄、早期活动和家属参与。

讨论

鉴于 COVID-19 大流行带来的重症治疗方面的新秩序，我们建议不要忽视通常的良好做法，而是要使这些做法适应所产生的特殊情况。我们的共识得到了科学证据、国家和国际经验的支持，并且将成为重症治疗中的一个有吸引力的咨询工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bdc/8075332/40638ce487d8/rbti-33-01-0048-g07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bdc/8075332/514641eec0a1/rbti-33-01-0048-g01.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bdc/8075332/c3c9d9796f19/rbti-33-01-0048-g06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bdc/8075332/40638ce487d8/rbti-33-01-0048-g07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bdc/8075332/514641eec0a1/rbti-33-01-0048-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bdc/8075332/6d323ba0af44/rbti-33-01-0048-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bdc/8075332/6b92f974fc64/rbti-33-01-0048-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bdc/8075332/2235506f61c1/rbti-33-01-0048-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bdc/8075332/01a5721e2598/rbti-33-01-0048-g05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bdc/8075332/c3c9d9796f19/rbti-33-01-0048-g06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bdc/8075332/40638ce487d8/rbti-33-01-0048-g07.jpg

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