Airway Hygiene in COVID-19 Pneumonia: Treatment Responses of 3 Critically Ill Cruise Ship Employees.
Identifieur interne : 001926 ( Main/Exploration ); précédent : 001925; suivant : 001927Airway Hygiene in COVID-19 Pneumonia: Treatment Responses of 3 Critically Ill Cruise Ship Employees.
Auteurs : Faryal I. Farooqi [États-Unis] ; Richard C. Morgan [États-Unis] ; Naveen Dhawan [États-Unis] ; John Dinh [États-Unis] ; George Yatzkan [États-Unis] ; George Michel [États-Unis]Source :
- The American journal of case reports [ 1941-5923 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Antipaludiques (usage thérapeutique), Betacoronavirus (MeSH), Humains (MeSH), Hydroxychloroquine (usage thérapeutique), Hygiène (MeSH), Infections à coronavirus (thérapie), Infections à coronavirus (transmission), Maladie grave (thérapie), Mâle (MeSH), Navires (MeSH), Pandémies (MeSH), Pneumopathie virale (thérapie), Pneumopathie virale (transmission), Sujet âgé (MeSH), Transmission de maladie infectieuse (prévention et contrôle), Ventilation artificielle (méthodes).
- MESH :
- méthodes : Ventilation artificielle.
- prévention et contrôle : Transmission de maladie infectieuse.
- thérapie : Infections à coronavirus, Maladie grave, Pneumopathie virale.
- usage thérapeutique : Antipaludiques, Hydroxychloroquine, Infections à coronavirus, Pneumopathie virale.
- Adulte d'âge moyen, Betacoronavirus, Humains, Hygiène, Mâle, Navires, Pandémies, Sujet âgé.
English descriptors
- KwdEn :
- Aged (MeSH), Antimalarials (therapeutic use), Betacoronavirus (MeSH), COVID-19 (MeSH), Coronavirus Infections (therapy), Coronavirus Infections (transmission), Critical Illness (therapy), Disease Transmission, Infectious (prevention & control), Humans (MeSH), Hydroxychloroquine (therapeutic use), Hygiene (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (therapy), Pneumonia, Viral (transmission), Respiration, Artificial (methods), SARS-CoV-2 (MeSH), Ships (MeSH).
- MESH :
- chemical , therapeutic use : Antimalarials, Hydroxychloroquine.
- methods : Respiration, Artificial.
- prevention & control : Disease Transmission, Infectious.
- therapy : Coronavirus Infections, Critical Illness, Pneumonia, Viral.
- transmission : Coronavirus Infections, Pneumonia, Viral.
- Aged, Betacoronavirus, COVID-19, Humans, Hygiene, Male, Middle Aged, Pandemics, SARS-CoV-2, Ships.
Abstract
BACKGROUND COVID-19, the disease entity caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2), continues to pose a major therapeutic challenge for clinicians. At present, an effective treatment regimen and vaccination has not been established. Many patients develop severe symptoms requiring endotracheal intubation and a prolonged stay in the Intensive Care Unit (ICU). In early postmortem examinations of COVID-19 patients, profuse viscous secretions were observed throughout the respiratory tract. Thus, oxygen supplementation without aggressive pulmonary hygiene management may be suboptimal. In the present case series, pulmonary hygiene management encompassed mucolytics, bronchodilators, and tracheal suctioning. We report 3 severe cases of COVID-19 pneumonia in cruise ship employees who were admitted to the ICU and responded to supportive mechanical ventilation and pulmonary hygiene management. CASE REPORT Three cruise ship employees with COVID-19 underwent endotracheal intubation and were admitted to the ICU for acute hypoxemic respiratory failure. Initial chest X-rays suggested multifocal pneumonia with superimposed acute respiratory distress syndrome (ARDS). A regimen of hydroxychloroquine, azithromycin, and dexamethasone was initiated on admission in all cases. Additionally, medications used for pulmonary hygiene were administered through a metered-dose inhaler (MDI) in line with the ventilator circuit. Endotracheal suctioning was performed prior to medication administration. The duration from endotracheal intubation to extubation ranged from 9 to 24 days. All 3 patients reached 30-day survival. CONCLUSIONS The cases reported highlight the importance of the use of airway hygiene with mucolytics, bronchodilators, and tracheal suctioning for patients with COVID-19 pneumonia requiring ventilatory support.
DOI: 10.12659/AJCR.926596
PubMed: 32810081
PubMed Central: PMC7458693
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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<term>Critical Illness (therapy)</term>
<term>Disease Transmission, Infectious (prevention & control)</term>
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<front><div type="abstract" xml:lang="en">BACKGROUND COVID-19, the disease entity caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2), continues to pose a major therapeutic challenge for clinicians. At present, an effective treatment regimen and vaccination has not been established. Many patients develop severe symptoms requiring endotracheal intubation and a prolonged stay in the Intensive Care Unit (ICU). In early postmortem examinations of COVID-19 patients, profuse viscous secretions were observed throughout the respiratory tract. Thus, oxygen supplementation without aggressive pulmonary hygiene management may be suboptimal. In the present case series, pulmonary hygiene management encompassed mucolytics, bronchodilators, and tracheal suctioning. We report 3 severe cases of COVID-19 pneumonia in cruise ship employees who were admitted to the ICU and responded to supportive mechanical ventilation and pulmonary hygiene management. CASE REPORT Three cruise ship employees with COVID-19 underwent endotracheal intubation and were admitted to the ICU for acute hypoxemic respiratory failure. Initial chest X-rays suggested multifocal pneumonia with superimposed acute respiratory distress syndrome (ARDS). A regimen of hydroxychloroquine, azithromycin, and dexamethasone was initiated on admission in all cases. Additionally, medications used for pulmonary hygiene were administered through a metered-dose inhaler (MDI) in line with the ventilator circuit. Endotracheal suctioning was performed prior to medication administration. The duration from endotracheal intubation to extubation ranged from 9 to 24 days. All 3 patients reached 30-day survival. CONCLUSIONS The cases reported highlight the importance of the use of airway hygiene with mucolytics, bronchodilators, and tracheal suctioning for patients with COVID-19 pneumonia requiring ventilatory support.</div>
</front>
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<Abstract><AbstractText>BACKGROUND COVID-19, the disease entity caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2), continues to pose a major therapeutic challenge for clinicians. At present, an effective treatment regimen and vaccination has not been established. Many patients develop severe symptoms requiring endotracheal intubation and a prolonged stay in the Intensive Care Unit (ICU). In early postmortem examinations of COVID-19 patients, profuse viscous secretions were observed throughout the respiratory tract. Thus, oxygen supplementation without aggressive pulmonary hygiene management may be suboptimal. In the present case series, pulmonary hygiene management encompassed mucolytics, bronchodilators, and tracheal suctioning. We report 3 severe cases of COVID-19 pneumonia in cruise ship employees who were admitted to the ICU and responded to supportive mechanical ventilation and pulmonary hygiene management. CASE REPORT Three cruise ship employees with COVID-19 underwent endotracheal intubation and were admitted to the ICU for acute hypoxemic respiratory failure. Initial chest X-rays suggested multifocal pneumonia with superimposed acute respiratory distress syndrome (ARDS). A regimen of hydroxychloroquine, azithromycin, and dexamethasone was initiated on admission in all cases. Additionally, medications used for pulmonary hygiene were administered through a metered-dose inhaler (MDI) in line with the ventilator circuit. Endotracheal suctioning was performed prior to medication administration. The duration from endotracheal intubation to extubation ranged from 9 to 24 days. All 3 patients reached 30-day survival. CONCLUSIONS The cases reported highlight the importance of the use of airway hygiene with mucolytics, bronchodilators, and tracheal suctioning for patients with COVID-19 pneumonia requiring ventilatory support.</AbstractText>
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