[The keypoints in treatment of the critical coronavirus disease 2019 patient].
Identifieur interne : 000A04 ( Ncbi/Merge ); précédent : 000A03; suivant : 000A05[The keypoints in treatment of the critical coronavirus disease 2019 patient].
Auteurs : X Y Li [République populaire de Chine] ; B. Du [République populaire de Chine] ; Y S Wang [République populaire de Chine] ; H Y J. Kang [République populaire de Chine] ; F. Wang [République populaire de Chine] ; B. Sun [République populaire de Chine] ; H B Qiu [République populaire de Chine] ; Z H Tong [République populaire de Chine]Source :
- Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases [ 1001-0939 ] ; 2020.
Abstract
The treatment of critically ill patients with coronavirus disease 2019(COVID-19) faces compelling challenges. In this issue, we'd like to share our first-line treatment experience in treating COVID-19. Hemodynamics need be closely monitored and different types of shock should be distinguished. Vasoconstrictor drugs should be used rationally and alerting of complications is of the same importance. The risk of venous thromboembolism (VTE) needs to be assessed, and effective prevention should be carried out for high-risk patients. It is necessary to consider the possibility of pulmonary thromboembolism (PTE) in patients with sudden onset of oxygenation deterioration, respiratory distress, reduced blood pressure. However, comprehensive analysis of disease state should be taken into the interpretation of abnormally elevated D-Dimer. Nutritional support is the basis of treatment. It's important to establish individual therapy regimens and to evaluate, monitor and adjust dynamically. Under the current epidemic situation, convalescent plasma can only be used empirically, indications need to be strictly screened, the blood transfusion process should be closely monitored and the curative effect should be dynamically evaluated.
DOI: 10.3760/cma.j.cn112147-20200224-00159
PubMed: 32111113
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Du</name><affiliation wicri:level="1"><nlm:affiliation>Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Wang, Y S" sort="Wang, Y S" uniqKey="Wang Y" first="Y S" last="Wang">Y S Wang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Kang, H Y J" sort="Kang, H Y J" uniqKey="Kang H" first="H Y J" last="Kang">H Y J. Kang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Wang, F" sort="Wang, F" uniqKey="Wang F" first="F" last="Wang">F. 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Du</name><affiliation wicri:level="1"><nlm:affiliation>Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Wang, Y S" sort="Wang, Y S" uniqKey="Wang Y" first="Y S" last="Wang">Y S Wang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Kang, H Y J" sort="Kang, H Y J" uniqKey="Kang H" first="H Y J" last="Kang">H Y J. Kang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Wang, F" sort="Wang, F" uniqKey="Wang F" first="F" last="Wang">F. Wang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Sun, B" sort="Sun, B" uniqKey="Sun B" first="B" last="Sun">B. Sun</name><affiliation wicri:level="1"><nlm:affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Qiu, H B" sort="Qiu, H B" uniqKey="Qiu H" first="H B" last="Qiu">H B Qiu</name><affiliation wicri:level="1"><nlm:affiliation>Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009</wicri:regionArea><wicri:noRegion>Nanjing 210009</wicri:noRegion></affiliation></author><author><name sortKey="Tong, Z H" sort="Tong, Z H" uniqKey="Tong Z" first="Z H" last="Tong">Z H Tong</name><affiliation wicri:level="1"><nlm:affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author></analytic><series><title level="j">Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases</title><idno type="ISSN">1001-0939</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The treatment of critically ill patients with coronavirus disease 2019(COVID-19) faces compelling challenges. In this issue, we'd like to share our first-line treatment experience in treating COVID-19. Hemodynamics need be closely monitored and different types of shock should be distinguished. Vasoconstrictor drugs should be used rationally and alerting of complications is of the same importance. The risk of venous thromboembolism (VTE) needs to be assessed, and effective prevention should be carried out for high-risk patients. It is necessary to consider the possibility of pulmonary thromboembolism (PTE) in patients with sudden onset of oxygenation deterioration, respiratory distress, reduced blood pressure. However, comprehensive analysis of disease state should be taken into the interpretation of abnormally elevated D-Dimer. Nutritional support is the basis of treatment. It's important to establish individual therapy regimens and to evaluate, monitor and adjust dynamically. Under the current epidemic situation, convalescent plasma can only be used empirically, indications need to be strictly screened, the blood transfusion process should be closely monitored and the curative effect should be dynamically evaluated.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32111113</PMID><DateRevised><Year>2020</Year><Month>02</Month><Day>29</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">1001-0939</ISSN><JournalIssue CitedMedium="Print"><Volume>43</Volume><Issue>0</Issue><PubDate><Year>2020</Year><Month>Feb</Month><Day>29</Day></PubDate></JournalIssue><Title>Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases</Title><ISOAbbreviation>Zhonghua Jie He He Hu Xi Za Zhi</ISOAbbreviation></Journal><ArticleTitle>[The keypoints in treatment of the critical coronavirus disease 2019 patient].</ArticleTitle><Pagination><MedlinePgn>E026</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3760/cma.j.cn112147-20200224-00159</ELocationID><Abstract><AbstractText>The treatment of critically ill patients with coronavirus disease 2019(COVID-19) faces compelling challenges. In this issue, we'd like to share our first-line treatment experience in treating COVID-19. Hemodynamics need be closely monitored and different types of shock should be distinguished. Vasoconstrictor drugs should be used rationally and alerting of complications is of the same importance. The risk of venous thromboembolism (VTE) needs to be assessed, and effective prevention should be carried out for high-risk patients. It is necessary to consider the possibility of pulmonary thromboembolism (PTE) in patients with sudden onset of oxygenation deterioration, respiratory distress, reduced blood pressure. However, comprehensive analysis of disease state should be taken into the interpretation of abnormally elevated D-Dimer. Nutritional support is the basis of treatment. It's important to establish individual therapy regimens and to evaluate, monitor and adjust dynamically. Under the current epidemic situation, convalescent plasma can only be used empirically, indications need to be strictly screened, the blood transfusion process should be closely monitored and the curative effect should be dynamically evaluated.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Li</LastName><ForeName>X Y</ForeName><Initials>XY</Initials><AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Du</LastName><ForeName>B</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Y S</ForeName><Initials>YS</Initials><AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kang</LastName><ForeName>H Y J</ForeName><Initials>HYJ</Initials><AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>F</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sun</LastName><ForeName>B</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Qiu</LastName><ForeName>H B</ForeName><Initials>HB</Initials><AffiliationInfo><Affiliation>Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tong</LastName><ForeName>Z H</ForeName><Initials>ZH</Initials><AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.</Affiliation></AffiliationInfo></Author></AuthorList><Language>chi</Language><GrantList CompleteYN="Y"><Grant><GrantID>2020YFC0841300</GrantID><Agency>Ministry of Science and Technology emergency response project to pneumonia pandemic of novel coronavirus infection</Agency><Country></Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D004740">English Abstract</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>02</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>China</Country><MedlineTA>Zhonghua Jie He He Hu Xi Za Zhi</MedlineTA><NlmUniqueID>8712226</NlmUniqueID><ISSNLinking>1001-0939</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><OtherAbstract Type="Publisher" Language="chi"><AbstractText>新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）危重型患者的救治面临严峻挑战。循环状态需严密监测并鉴别不同类型的休克，合理应用血管收缩药物，警惕并发症。评估静脉血栓栓塞症（VTE）风险，高危者需实施有效预防，对突然出现氧合恶化、呼吸窘迫、血压下降等临床表现者需警惕肺血栓栓塞症（PTE）的发生，但对D-二聚体异常增高的解读需结合疾病的严重状态综合分析。营养支持作为基础治疗手段，应制定个体化营养方案，评估并动态调整。当前疫情下，恢复期血浆只能经验性应用，适应证需严格把控，输血过程中严密监测并动态评估疗效。.</AbstractText></OtherAbstract><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Convalescent plasma</Keyword><Keyword MajorTopicYN="N">Coronavirus disease 2019, COVID-19</Keyword><Keyword MajorTopicYN="N">Nutritional support</Keyword><Keyword MajorTopicYN="N">Vasoconstrictor drugs</Keyword><Keyword MajorTopicYN="N">Venous thromboembolism</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>3</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>3</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>3</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32111113</ArticleId><ArticleId IdType="doi">10.3760/cma.j.cn112147-20200224-00159</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>République populaire de Chine</li></country><settlement><li>Pékin</li></settlement></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Li, X Y" sort="Li, X Y" uniqKey="Li X" first="X Y" last="Li">X Y Li</name></noRegion><name sortKey="Du, B" sort="Du, B" uniqKey="Du B" first="B" last="Du">B. 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