Rev Panam Salud Publica. 2021 Nov 3;45:e128. doi: 10.26633/RPSP.2021.128. eCollection 2021.
In 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has spread around the world. Approximately 5% of infected patients are critical cases that require admission to the intensive care unit (ICU). In these patients, COVID-19 can be complicated by acute respiratory distress syndrome, septic shock, and multi-organ failure, including kidney and heart failure.
Summarize the recommendations included in the Guidelines for Care of Critically Ill Adult Patients with COVID-19 in the Americas, version 3, published by the Pan American Health Organization in 2021 to guide the management of critically ill adult patients with COVID-19 treated in the ICU, and address key aspects of implementation of the recommendations.
The guidelines and their recommendations were summarized. In addition, a systematic search was carried out in Pubmed, Lilacs, Health Systems Evidence, Epistemonikos, and gray literature on studies carried out in the Region of the Americas, in order to identify barriers, facilitators, and implementation strategies.
Forty-three recommendations are presented that address the identification of markers and risk factors for mortality, infection prevention and control, specimen collection, supportive care (ventilatory and hemodynamic), pharmacological treatment, early rehabilitation, use of imaging studies, prevention of complications, and discharge criteria for critical patients with COVID-19.
The recommendations seek to provide knowledge on the management of critical patients with COVID-19 and offer considerations for implementation of the recommendations in the Region.
2020年,世界卫生组织宣布由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的2019冠状病毒病(COVID-19)大流行,该病已在全球蔓延。约5%的感染患者为危重症病例,需要入住重症监护病房(ICU)。在这些患者中,COVID-19可能并发急性呼吸窘迫综合征、感染性休克和多器官功能衰竭,包括肾衰竭和心力衰竭。
总结泛美卫生组织于2021年发布的《美洲成人COVID-19危重症患者护理指南》第3版中包含的建议,以指导在ICU接受治疗的成人COVID-19危重症患者的管理,并阐述建议实施的关键方面。
对指南及其建议进行了总结。此外,还在PubMed、Lilacs、卫生系统证据、Epistemonikos以及关于在美洲地区开展的研究的灰色文献中进行了系统检索,以确定障碍、促进因素和实施策略。
提出了43条建议,涉及COVID-19危重症患者死亡率标志物和危险因素的识别、感染预防与控制、标本采集、支持治疗(通气和血流动力学)、药物治疗、早期康复、影像学检查的使用、并发症预防以及出院标准。
这些建议旨在提供有关COVID-19危重症患者管理的知识,并为在该地区实施这些建议提供考虑因素。