Experience of treating severe cases of 2019 novel coronavirus pneumonia in Changde area
10.3760/cma.j.issn.2095-4352.2020.01.005
- VernacularTitle: 常德地区定点医院收治新型冠状病毒肺炎危重型病例救治经验分享
- Author:
Xin JIN
1
;
Yimin FANG
1
;
Shaohua HUANG
1
;
Lin LUO
1
;
Yunjian QIN
1
;
Rui ZHOU
1
;
Yue PENG
1
;
Mingshi YANG
1
;
Yuhang AI
1
Author Information
1. Department of Critical Medicine, Xiangya Third Hospital, Central South University, Changsha 410000, Hunan, China
- Publication Type:Journal Article
- Keywords:
2019 Novel coronavirus pneumonia;
Critical case;
Treatment experience
- From:
Chinese Critical Care Medicine
2020;32(1):10-12
- CountryChina
- Language:Chinese
-
Abstract:
Since the cluster of the 2019 novel coronavirus (2019-nCoV) pneumonia, a large number of patients gathered, the mortality of critical patients has remained high and the treatment was unclear. In this outbreak, Hunan Changde region immediately set up a hospital and intensive care unit. The patients relieved through respiratory support, hemodynamics management, nutritional support, the application of antiviral drugs, analgesic and sedation. The treatment experience in severe cases of 2019-nCov pneumonia patients were summarized as follows: in terms of respiratory support, we needed to pay attention to the advantages of high-flow nasal cannula oxygen therapy (HFNC) and the intervention of mechanical ventilation, pay attention to the ventilator parameters, and adopt prone position timely. In the aspects of fluid resuscitation and volume management, we should pay attention to the characteristics of severe patients' volume status, perform early evaluation, and clinicians should focused on hemodynamic management beside the bed. In the aspect of nutritional support and evaluation and maintenance of intestinal function, early enteral nutrition should be adopted in time. However, the trade-off between the risk of intestinal function and nutritional support in patients with mechanical ventilation and the antiviral benefits of Kaletra needed to be reevaluated, the optimized way of analgesia and sedation was adopted, at the same time, the usage and side effects of antiviral drugs should be paid attention to. We should grasp the opportunity of transportation for severe patients. It is suggested that some warning scores should be used to facilitate early recognition of patients with severe infection and then they should be earlier transferred to the designated hospital for intensive care.
