Intensive Care Management in COVID-19 Patients

Year 2020, , 107 - 114, 31.08.2020

Yakup Tomak , Kezban Özmen Süner

https://doi.org/10.34084/bshr.748495

Cited By: 1

Abstract

In December 2019,outbreak of pneumonia,in Wuhan , was identified as coronovirus disease 2019 (COVID-19).The clinical findings of COVID-19 have been observed in a wide spectrum of mild symptoms such as asymptomatic disease and upper respiratory tract infection, leading to severe viral pneumoniaswith respiratory failure that can result in death.Critical patients with acute hypoxemic respiratory failure, shock, myocardial dysfunction, acute kidney injury and multiple organ failure are among the patients who require intensive care follow-up.
It reported the overall mortality rate as 2.3% in COVID-19, but although mortality is 49.0% in critically ill patients, it is more than 50% in those receiving invasive mechanical ventilation support.Therefore, intensive care management is important for mortality of critical COVID-19 patients.In this review, we aimed to explain the intensive care follow-up and treatments of critical COVID-19 patients.

Keywords

COVID-19, Managemnet, Intensive care

COVİD-19 Hastalarında Yoğun Bakım Yönetimi

Abstract

Aralık 2019’da, Çin’in Wuhan şehrinin merkezi olduğu pnömoni salgını, Coronavirüs hastalığı 2019 (COVID-19) olarak tanımlanmıştır.COVID-19'un klinik bulgularının asemptomatik hastalık ve üst solunum yolu enfeksiyonu gibi hafif tablolardan başlayıp solunum yetmezliğinin eşlik ettiği ve ölümlerle sonuçlanabilen ağır viral pnömonilere varan geniş spektrumda olduğu gözlenmiştir. Yoğun bakım izlemi gerektiren hastalar içerisinde Acute Respiratory Distress Syndrome (ARDS) içeren akut hipoksemik solunum yetmezliği, şok, miyokardiyal disfonksiyon , akut böbrek hasarıve çoklu organ yetmezliği gelişen kritik hastalar mevcuttur. COVID-19' da genel mortalite oranını %2.3 olarak bildirmiştir, ancak kritik hastalarda mortalite %49.0 olmasına rağmen invaziv mekanik ventilasyon desteği alanlarda ise bu %50’nin de üzerindedir. Bu nedenle kritik COVID-19 hastalarında yoğun bakım yönetimi mortalite açısından oldukça önemli bir yer tutmaktadır. Bu derlemede kritik COVID-19 hastalarının yoğun bakım takip ve tedavilerini anlatmayı hedefledik.

Keywords

COVİD-19, yoğun bakım, yoğun bakım yönetimi

References

• Kaynaklar 1-Phua J, Weng L, Ling L, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med 2020;8:506-517 2- Wu Z, McGoogan JM, (2020) Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA; doi: 10.1001/jama.2020.2648 3-T.C Sağlık Bakanlığı. Covıd-19-Sars-Cov-2 Enfeksiyonu Rehberi (Bilim Kurulu Çalışması) 14.4.2020 4- JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S, Prat G, Boulain T, Morawiec E, Cottereau A, Devaquet J, Nseir S, Razazi K, Mira JP, Argaud L, Chakarian JC, Ricard JD, Wittebole X, Chevalier S, Herbland A, Fartoukh M, Constantin JM, Tonnelier JM, Pierrot M, Mathonnet A, Beduneau G, Deletage-Metreau C, Richard JC, Brochard L, Robert R, Group FS, Network R, (2015) High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med 372: 2185-2196 5- Ni YN, Luo J, Yu H, Liu D, Liang BM, Liang ZA, (2018) The effect of high-flow nasal cannula in reducing the mortality and the rate of endotracheal intubation when used before mechanical ventilation compared with conventional oxygen therapy and noninvasive positive pressure ventilation. A systematic review and meta-analysis. Am J Emerg Med 36: 226-233 6-Kang BJ, Koh Y, Lim CM, et al. Failure of high-flow nasal cannula therapy may delay intubation and increase mortality. Intensive Care Med 2015; 41: 623–32. 7- Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One 2012; 7: e35797. 8-Alraddadi BM, Qushmaq I, Al-Hameed FM, Mandourah Y, Almekhlafi GA, Jose J, Al-Omari A, Kharaba A, Almotairi A, Al Khatib K, Shalhoub S, Abdulmomen A, Mady A, Solaiman O, Al-Aithan AM, Al-Raddadi R, Ragab A, Balkhy HH, Al Harthy A, Sadat M, Tlayjeh H, Merson L, Hayden FG, Fowler RA, Arabi YM, Saudi Critical Care Trials G, (2019) Noninvasive ventilation in critically ill patients with the Middle East respiratory syndrome. Influenza Other Respir Viruses 13: 382-390 9-Arabi YM, Arifi AA, Balkhy HH, Najm H, Aldawood AS, Ghabashi A, Hawa H, Alothman A, Khaldi A, Al Raiy B, (2014) Clinical course and outcomes of critically ill patients with Middle East respiratory syndrome coronavirus infection. Ann Intern Med 160: 389-397 10-Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. Surviving Sepsis campaign: Guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med 2020 11-Gattinoni L, Chiumello D, Rossi S. COVID-19 pneumonia: ARDS or not? Criticale Care. 2020;24:154. 12-Brochard L, Slutsky A, Pesenti A. Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med. 2017;195(4):438-442. doi:10.1164/rccm.201605-1081CPPubMedGoogle ScholarCrossref 13- John J.Marini,MD; Luciano Gattinoni, MD Management of COVID-19 Respiratory Distress JAMA Published online April 24, 2020. doi:10.1001/jama.2020.6825
• 14- Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-1062.doi:10.1016/S0140-6736(20)30566-3PubMedGoogle ScholarCrossref 15-Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020 epublished 16-COVID-19 and its implications for thrombosis and anticoagulation .Jean M. Connors, MD1 ; Jerrold H. Levy, M.D., FAHA, FCCM American Society of Hematology 17-Wu Z, McGoogan JM, (2020) Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA; doi: 10.1001/jama.2020.2648 18-Wang Y, Jiang W, He Q, Wang C, Wang B, Zhou P, Dong N, Tong Q, (2020) Early, low-dose and short-term application of corticosteroid treatment in patients with severe COVID-19 pneumonia: single-center experience from Wuhan, China. medRxiv: 2020.2003.2006.20032342 19-Rice TW, Rubinson L, Uyeki TM, Vaughn FL, John BB, Miller RR, 3rd, Higgs E, Randolph AG, Smoot BE, Thompson BT, Network NA, (2012) Critical illness from 2009 pandemic influenza A virus and bacterial coinfection in the United States. Crit Care Med 40: 1487-1498 20-Shieh WJ, Blau DM, Denison AM, Deleon-Carnes M, Adem P, Bhatnagar J, Sumner J, Liu L, Patel M, Batten B, Greer P, Jones T, Smith C, Bartlett J, Montague J, White E, Rollin D, Gao R, Seales C, Jost H, Metcalfe M, Goldsmith CS, Humphrey C, Schmitz A, Drew C, Paddock C, Uyeki TM, Zaki SR, (2010) 2009 pandemic influenza A (H1N1): pathology and pathogenesis of 100 fatal cases in the United States. Am J Pathol 177: 166-175 21. McCullers JA, (2013) Do specific virus-bacteria pairings drive clinical outcomes of pneumonia? Clin Microbiol Infect 19: 113-118 22-Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B, (2020) Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395: 497-506 23-Alhazzani W, Møller MH, Arabi YM, et al. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Crit Care Med 2020. 24-Shakoory B, Carcillo JA, Chatham WW, Amdur RL, Zhao H, Dinarello CA, et al. Interleukin-1 receptor blockade is associated with reduced mortality in sepsis patients with features of macrophage activation syndrome: reanalysis of a prior phase III trial. Critical Care Med 2016;44(2):275–81 PubMed PMID: 26584195. eng. 25-The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID-19 Qing Ye, Bili Wang, Jianhua Mao Journal of Infection [m5G;April 13, 2020;17:20] 26- K X, H C, Y S, Q N, Y C, S H, et al. Management of corona virus disease-19 (COVID-19): the Zhejiang experience. Zhejiang da xue xue bao Yi xue ban 2020;49(1):0 PubMed PMID: 32096367 27-Duan K. The feasibility of convalescent plasma therapy in severe COVID-19 patients: a pilot study. 2020. https://doi.org/10.1101/2020031620036145 28-China puts 245 COVID-19 patients on convalescent plasma therapy. News release. Xinhua. February 28, 2020. Available at: http://www.xinhuanet.com/english/ 2020-02/28/c_138828177.htm. Accessed March 10, 2020. 29-China Seeks Plasma From Recovered Patients to Treat Virus. Time. Available from: https://time.com/5784286/covid-19-china-plasma-treatment/. [cited 2020 Feb 16] 30-ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection, Clinical Nutrition, https://doi.org/10.1016/j.clnu.2020.03.022