tetano
Editor, Senior Moderator
Front Med
. 2020 Aug 6.
doi: 10.1007/s11684-020-0796-3. Online ahead of print.
Successful management of seven cases of critical COVID-19 with early noninvasive-invasive sequential ventilation algorithm and bundle pharmacotherapy
Mian Peng[SUP] 1 [/SUP], Xueyan Liu[SUP] 2 [/SUP], Jinxiu Li[SUP] 3 [/SUP], Di Ren[SUP] 4 [/SUP], Yongfeng Liu[SUP] 5 [/SUP], Xi Meng[SUP] 3 [/SUP], Yansi Lyu[SUP] 6 [/SUP], Ronglin Chen[SUP] 5 [/SUP], Baojun Yu[SUP] 7 [/SUP], Weixiong Zhong[SUP] 1 [/SUP]
Affiliations
Abstract
We report the clinical and laboratory findings and successful management of seven patients with critical coronavirus disease 2019 (COVID-19) requiring mechanical ventilation (MV). The patients were diagnosed based on epidemiological history, clinical manifestations, and nucleic acid testing. Upon diagnosis with COVID-19 of critical severity, the patients were admitted to the intensive care unit, where they received early noninvasive-invasive sequential ventilation, early prone positioning, and bundle pharmacotherapy regimen, which consists of antiviral, anti-inflammation, immune-enhancing, and complication-prophylaxis medicines. The patients presented fever (n = 7, 100%), dry cough (n = 3, 42.9%), weakness (n = 2, 28.6%), chest tightness (n = 1, 14.3%), and/or muscle pain (n = 1, 14.3%). All patients had normal or lower than normal white blood cell count/lymphocyte count, and chest computed tomography scans showed bilateral patchy shadows or ground glass opacity in the lungs. Nucleic acid testing confirmed COVID-19 in all seven patients. The median MV duration and intensive care unit stay were 9.9 days (interquartile range, 6.5-14.6 days; range, 5-17 days) and 12.9 days (interquartile range, 9.7-17.6 days; range, 7-19 days), respectively. All seven patients were extubated, weaned off MV, transferred to the common ward, and discharged as of the writing of this report. Thus, we concluded that good outcomes for patients with critical COVID-19 can be achieved with early noninvasive-invasive sequential ventilation and bundle pharmacotherapy.
Keywords: COVID-19; bundle pharmacotherapy; noninvasive-invasive sequential ventilation.
. 2020 Aug 6.
doi: 10.1007/s11684-020-0796-3. Online ahead of print.
Successful management of seven cases of critical COVID-19 with early noninvasive-invasive sequential ventilation algorithm and bundle pharmacotherapy
Mian Peng[SUP] 1 [/SUP], Xueyan Liu[SUP] 2 [/SUP], Jinxiu Li[SUP] 3 [/SUP], Di Ren[SUP] 4 [/SUP], Yongfeng Liu[SUP] 5 [/SUP], Xi Meng[SUP] 3 [/SUP], Yansi Lyu[SUP] 6 [/SUP], Ronglin Chen[SUP] 5 [/SUP], Baojun Yu[SUP] 7 [/SUP], Weixiong Zhong[SUP] 1 [/SUP]
Affiliations
- PMID: 32761492
- DOI: 10.1007/s11684-020-0796-3
Abstract
We report the clinical and laboratory findings and successful management of seven patients with critical coronavirus disease 2019 (COVID-19) requiring mechanical ventilation (MV). The patients were diagnosed based on epidemiological history, clinical manifestations, and nucleic acid testing. Upon diagnosis with COVID-19 of critical severity, the patients were admitted to the intensive care unit, where they received early noninvasive-invasive sequential ventilation, early prone positioning, and bundle pharmacotherapy regimen, which consists of antiviral, anti-inflammation, immune-enhancing, and complication-prophylaxis medicines. The patients presented fever (n = 7, 100%), dry cough (n = 3, 42.9%), weakness (n = 2, 28.6%), chest tightness (n = 1, 14.3%), and/or muscle pain (n = 1, 14.3%). All patients had normal or lower than normal white blood cell count/lymphocyte count, and chest computed tomography scans showed bilateral patchy shadows or ground glass opacity in the lungs. Nucleic acid testing confirmed COVID-19 in all seven patients. The median MV duration and intensive care unit stay were 9.9 days (interquartile range, 6.5-14.6 days; range, 5-17 days) and 12.9 days (interquartile range, 9.7-17.6 days; range, 7-19 days), respectively. All seven patients were extubated, weaned off MV, transferred to the common ward, and discharged as of the writing of this report. Thus, we concluded that good outcomes for patients with critical COVID-19 can be achieved with early noninvasive-invasive sequential ventilation and bundle pharmacotherapy.
Keywords: COVID-19; bundle pharmacotherapy; noninvasive-invasive sequential ventilation.