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新型冠状病毒肺炎相关急性呼吸窘迫综合征:多学科视角下的护理挑战评估、研究综述及建议

COVID-19 ARDS: A Multispecialty Assessment of Challenges in Care, Review of Research, and Recommendations.

作者信息

Sasidharan Shibu, Singh Vijay, Singh Jaskanwar, Madan Gurdarshdeep Singh, Dhillon Harpreet Singh, Dash Prasanta K, Shibu Babitha, Dhillon Gurpreet Kaur

机构信息

Department of Anaesthesiology and Critical Care, Level III IFH MONUSCO, Goma, Democratic Republic of the Congo.

Department of Internal Medicine, Level III IFH MONUSCO, Goma, Democratic Republic of the Congo.

出版信息

J Anaesthesiol Clin Pharmacol. 2021 Apr-Jun;37(2):179-195. doi: 10.4103/joacp.JOACP_14_21. Epub 2021 Jul 15.

Abstract

Physicians and care providers are familiar with the management of ARDS, however, when it occurs as a sequalae of COVID-19, it has different features and there remains uncertainty on the consensus of management. To answer this question on how it compares and contrasts with ARDS from other causes, the authors reviewed the published literature and management guidelines as well as their own clinical experience while managing patients with COVID-19 ARDS. For research, a PubMed search was conducted on 01.04.2021 using the systematic review filter to identify articles that were published using MeSH terms COVID-19 and ARDS. Systematic reviews or meta-analyses were selected from a systematic search for literature containing diagnostic, prognostic and management strategies in MEDLINE/PubMed. Those were compared and reviewed to the existing practices by the various treating specialists and recommendations were made. Specifically, the COVID-19 ARDS, its risk factors and pathophysiology, lab diagnosis, radiological findings, rational of recommendation of drugs proposed so far, oxygenation and ventilation strategies and the psychological ramifications of the disease were. discussed. Because of the high mortality in mechanically ventilated patients, the above recommendations and findings direct the potential for improvement in the management of patients with COVID-19 ARDS.

摘要

医生和护理人员对急性呼吸窘迫综合征(ARDS)的管理很熟悉,然而,当它作为2019冠状病毒病(COVID-19)的后遗症出现时,具有不同的特征,并且在管理共识方面仍存在不确定性。为了回答它与其他原因导致的ARDS相比有何异同这一问题,作者回顾了已发表的文献、管理指南以及他们自己在治疗COVID-19相关ARDS患者时的临床经验。在研究方面,于2021年4月1日使用系统评价筛选器在PubMed上进行检索,以识别使用医学主题词COVID-19和ARDS发表的文章。从系统检索MEDLINE/PubMed中包含诊断、预后和管理策略的文献中选择系统评价或荟萃分析。将这些与不同治疗专家的现有实践进行比较和审查,并提出建议。具体讨论了COVID-19相关ARDS、其危险因素和病理生理学、实验室诊断、影像学表现、迄今提出的药物推荐依据、氧合和通气策略以及该疾病的心理影响。由于机械通气患者的高死亡率,上述建议和发现为改善COVID-19相关ARDS患者的管理提供了可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/970f/8289635/1b7c11924c59/JOACP-37-179-g001.jpg

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