German recommendations for critically ill patients with COVID‑19
Identifieur interne : 003E55 ( Ncbi/Merge ); précédent : 003E54; suivant : 003E56German recommendations for critically ill patients with COVID‑19
Auteurs : Stefan Kluge [Allemagne] ; Uwe Janssens [Allemagne] ; Tobias Welte [Allemagne] ; Steffen Weber-Carstens [Allemagne] ; Gernot Marx [Allemagne] ; Christian Karagiannidis [Allemagne]Source :
- Medizinische Klinik, Intensivmedizin Und Notfallmedizin [ 2193-6218 ] ; 2020.
Abstract
Since December 2019, a novel coronavirus (severe acute respiratory syndrome—coronavirus 2, SARS-CoV-2) has rapidly spread around the world resulting in an acute respiratory illness pandemic. The majority of patients presents with mild symptoms of coronavirus disease 2019 (COVID-19). However, about 5% become critically ill and require intensive care treatment. Acute hypoxemic failure with severe dyspnea and an increased respiratory rate (>30/min) usually leads to ICU admission. At that point, bilateral pulmonary infiltrates are typically seen. Patients often develop a severe acute respiratory distress syndrome (ARDS). To date there is no specific treatment available—the main goal of supportive therapy is to ascertain adequate oxygenation. Early intubation and repeated prone positioning are key elements in treating hypoxemic COVID-19 patients. Strict adherence to basic infection control measures (including hand hygiene) and use of personal protection equipment (PPE) are essential in the care of patients. Procedures that lead to formation of aerosols should be avoided where possible and carried out with utmost precaution.
Url:
DOI: 10.1007/s00063-020-00689-w
PubMed: NONE
PubMed Central: 7155395
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wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.491773.f</institution-id><institution>German Interdisciplinary Association of Critical Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin [DIVI]),</institution></institution-wrap>Berlin, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Berlin</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="GRID">grid.491767.a</institution-id><institution-id institution-id-type="ISNI">0000 0001 1091 8411</institution-id><institution>German Society of Anaesthesiology and Intensive Care Medicine (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin [DGAI]),</institution></institution-wrap>Nürnberg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Nürnberg</wicri:regionArea></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff5">ARDS Network Germany, Berlin, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>ARDS Network Germany, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Karagiannidis, Christian" sort="Karagiannidis, Christian" uniqKey="Karagiannidis C" first="Christian" last="Karagiannidis">Christian Karagiannidis</name><affiliation wicri:level="3"><nlm:aff id="Aff1">German Society of Medical Intensive Care and Emergency Medicine (Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin [DGIIN]), Berlin, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>German Society of Medical Intensive Care and Emergency Medicine (Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin [DGIIN]), Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.491773.f</institution-id><institution>German Interdisciplinary Association of Critical Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin [DIVI]),</institution></institution-wrap>Berlin, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Berlin</wicri:regionArea></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff5">ARDS Network Germany, Berlin, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>ARDS Network Germany, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author></analytic><series><title level="j">Medizinische Klinik, Intensivmedizin Und Notfallmedizin</title><idno type="ISSN">2193-6218</idno><idno type="eISSN">2193-6226</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Since December 2019, a novel coronavirus (severe acute respiratory syndrome—coronavirus 2, SARS-CoV-2) has rapidly spread around the world resulting in an acute respiratory illness pandemic. The majority of patients presents with mild symptoms of coronavirus disease 2019 (COVID-19). However, about 5% become critically ill and require intensive care treatment. Acute hypoxemic failure with severe dyspnea and an increased respiratory rate (>30/min) usually leads to ICU admission. At that point, bilateral pulmonary infiltrates are typically seen. Patients often develop a severe acute respiratory distress syndrome (ARDS). To date there is no specific treatment available—the main goal of supportive therapy is to ascertain adequate oxygenation. Early intubation and repeated prone positioning are key elements in treating hypoxemic COVID-19 patients. Strict adherence to basic infection control measures (including hand hygiene) and use of personal protection equipment (PPE) are essential in the care of patients. Procedures that lead to formation of aerosols should be avoided where possible and carried out with utmost precaution.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Xie, J" uniqKey="Xie J">J Xie</name></author><author><name sortKey="Tong, Z" uniqKey="Tong Z">Z Tong</name></author><author><name sortKey="Guan, X" uniqKey="Guan X">X Guan</name></author><author><name sortKey="Du, B" uniqKey="Du B">B Du</name></author><author><name sortKey="Qiu, H" uniqKey="Qiu H">H Qiu</name></author><author><name sortKey="Slutsky, As" uniqKey="Slutsky A">AS Slutsky</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wu, Z" uniqKey="Wu Z">Z Wu</name></author><author><name sortKey="Mcgoogan, Jm" uniqKey="Mcgoogan J">JM McGoogan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chung, M" uniqKey="Chung M">M Chung</name></author><author><name sortKey="Bernheim, A" uniqKey="Bernheim A">A 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Med Klin Intensivmed Notfmed</journal-id><journal-id journal-id-type="iso-abbrev">Med Klin Intensivmed Notfmed</journal-id><journal-title-group><journal-title>Medizinische Klinik, Intensivmedizin Und Notfallmedizin</journal-title></journal-title-group><issn pub-type="ppub">2193-6218</issn><issn pub-type="epub">2193-6226</issn><publisher><publisher-name>Springer Medizin</publisher-name><publisher-loc>Heidelberg</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">7155395</article-id><article-id pub-id-type="publisher-id">689</article-id><article-id pub-id-type="doi">10.1007/s00063-020-00689-w</article-id><article-categories><subj-group subj-group-type="heading"><subject>Guidelines and Recommendations</subject></subj-group></article-categories><title-group><article-title>German recommendations for critically ill patients with COVID‑19</article-title><trans-title-group><trans-title xml:lang="de">Empfehlungen zur intensivmedizinischen Therapie von Patienten mit COVID‑19</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Kluge</surname><given-names>Stefan</given-names></name><address><email>skluge@uke.de</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref><xref ref-type="aff" rid="Aff5">5</xref><xref ref-type="aff" rid="Aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Janssens</surname><given-names>Uwe</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref><xref ref-type="aff" rid="Aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Welte</surname><given-names>Tobias</given-names></name><xref ref-type="aff" rid="Aff3">3</xref><xref ref-type="aff" rid="Aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Weber-Carstens</surname><given-names>Steffen</given-names></name><xref ref-type="aff" rid="Aff4">4</xref><xref ref-type="aff" rid="Aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Marx</surname><given-names>Gernot</given-names></name><xref ref-type="aff" rid="Aff2">2</xref><xref ref-type="aff" rid="Aff4">4</xref><xref ref-type="aff" rid="Aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Karagiannidis</surname><given-names>Christian</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref><xref ref-type="aff" rid="Aff5">5</xref></contrib><aff id="Aff1"><label>1</label>German Society of Medical Intensive Care and Emergency Medicine (Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin [DGIIN]), Berlin, Germany</aff><aff id="Aff2"><label>2</label><institution-wrap><institution-id institution-id-type="GRID">grid.491773.f</institution-id><institution>German Interdisciplinary Association of Critical Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin [DIVI]),</institution></institution-wrap>Berlin, Germany</aff><aff id="Aff3"><label>3</label><institution-wrap><institution-id institution-id-type="GRID">grid.489525.7</institution-id><institution-id institution-id-type="ISNI">0000 0000 9320 5144</institution-id><institution>German Respiratory Society (Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin [DGP]),</institution></institution-wrap>Berlin, Germany</aff><aff id="Aff4"><label>4</label><institution-wrap><institution-id institution-id-type="GRID">grid.491767.a</institution-id><institution-id institution-id-type="ISNI">0000 0001 1091 8411</institution-id><institution>German Society of Anaesthesiology and Intensive Care Medicine (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin [DGAI]),</institution></institution-wrap>Nürnberg, Germany</aff><aff id="Aff5"><label>5</label>ARDS Network Germany, Berlin, Germany</aff><aff id="Aff6"><label>6</label><institution-wrap><institution-id institution-id-type="GRID">grid.13648.38</institution-id><institution-id institution-id-type="ISNI">0000 0001 2180 3484</institution-id><institution>Department of Intensive Care,</institution><institution>University Medical Center Hamburg-Eppendorf,</institution></institution-wrap>Martinistr. 52, 20246 Hamburg, Germany</aff></contrib-group><pub-date pub-type="epub"><day>14</day><month>4</month><year>2020</year></pub-date><fpage>1</fpage><lpage>4</lpage><permissions><copyright-statement>© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020</copyright-statement><license><license-p>This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.</license-p></license></permissions><abstract id="Abs1"><p>Since December 2019, a novel coronavirus (severe acute respiratory syndrome—coronavirus 2, SARS-CoV-2) has rapidly spread around the world resulting in an acute respiratory illness pandemic. The majority of patients presents with mild symptoms of coronavirus disease 2019 (COVID-19). However, about 5% become critically ill and require intensive care treatment. Acute hypoxemic failure with severe dyspnea and an increased respiratory rate (>30/min) usually leads to ICU admission. At that point, bilateral pulmonary infiltrates are typically seen. Patients often develop a severe acute respiratory distress syndrome (ARDS). To date there is no specific treatment available—the main goal of supportive therapy is to ascertain adequate oxygenation. Early intubation and repeated prone positioning are key elements in treating hypoxemic COVID-19 patients. Strict adherence to basic infection control measures (including hand hygiene) and use of personal protection equipment (PPE) are essential in the care of patients. Procedures that lead to formation of aerosols should be avoided where possible and carried out with utmost precaution.</p></abstract><trans-abstract xml:lang="de" id="Abs2"><p>Seit Dezember 2019 verbreitet sich das neuartige Coronavirus SARS-CoV‑2 (Severe Acute Respiratory Syndrome – Corona Virus-2) rasch im Sinne einer weltweiten Pandemie. Dies stellt Kliniker und Krankenhäuser vor große Herausforderungen und belastet die Gesundheitssysteme vieler Länder in einem nie dagewesenen Maß.</p><p>Die Mehrheit der Patienten zeigt lediglich milde Symptome der sogenannten <italic>Coronavirus Disease 2019</italic> (COVID-19). Dennoch benötigen etwa 5 % eine intensivmedizinische Behandlung. Die akute hypoxämische respiratorische Insuffizienz mit Dyspnoe und hoher Atemfrequenz (>30/min) führt in der Regel zur Aufnahme auf die Intensivstation. Oft finden sich dann bereits bilaterale pulmonale Infiltrate in der Bildgebung und im Verlauf entwickeln viele Patienten ein <italic>Acute Respiratory Distress Syndrome </italic>(ARDS).</p><p>Bisher gibt es noch keine zugelassene spezifische Therapieoption. Das Hauptziel der supportiven Therapie ist, eine ausreichende Oxygenierung sicherzustellen. Die frühe Intubation und wiederholte Bauchlagerung sind dabei wichtige Elemente in der Behandlung von hypoxämischen COVID-19 Patienten.</p><p>Die strikte Einhaltung der Basishygiene, einschließlich der Händehygiene, sowie das korrekte Tragen von adäquater persönlicher Schutzausrüstung ist im Umgang mit den Patienten unabdingbar. Prozeduren, die zur Aerosolbildung führen könnten, sollten, soweit möglich, vermieden, und, falls nötig, mit äußerster Sorgfalt und Vorbereitung durchgeführt werden.</p></trans-abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>COVID-19</kwd><kwd>Coronavirus</kwd><kwd>Acute respiratory failure</kwd><kwd>ARDS</kwd><kwd>High-flow nasal cannula</kwd></kwd-group><kwd-group xml:lang="de"><title>Schlüsselwörter</title><kwd>COVID-19</kwd><kwd>Coronavirus</kwd><kwd>Akute respiratorische Insuffizienz</kwd><kwd>ARDS</kwd><kwd>High-Flow-Sauerstofftherapie</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>Allemagne</li></country><region><li>Berlin</li><li>Hambourg</li></region><settlement><li>Berlin</li><li>Hambourg</li></settlement></list><tree><country name="Allemagne"><region name="Berlin"><name sortKey="Kluge, Stefan" sort="Kluge, Stefan" uniqKey="Kluge S" first="Stefan" last="Kluge">Stefan Kluge</name></region><name sortKey="Janssens, Uwe" sort="Janssens, Uwe" uniqKey="Janssens U" first="Uwe" last="Janssens">Uwe Janssens</name><name sortKey="Janssens, Uwe" sort="Janssens, Uwe" uniqKey="Janssens U" first="Uwe" last="Janssens">Uwe Janssens</name><name sortKey="Janssens, Uwe" sort="Janssens, Uwe" uniqKey="Janssens U" first="Uwe" last="Janssens">Uwe Janssens</name><name sortKey="Karagiannidis, Christian" sort="Karagiannidis, Christian" uniqKey="Karagiannidis C" first="Christian" last="Karagiannidis">Christian Karagiannidis</name><name sortKey="Karagiannidis, Christian" sort="Karagiannidis, Christian" uniqKey="Karagiannidis C" first="Christian" last="Karagiannidis">Christian Karagiannidis</name><name sortKey="Karagiannidis, Christian" sort="Karagiannidis, Christian" uniqKey="Karagiannidis C" first="Christian" last="Karagiannidis">Christian Karagiannidis</name><name sortKey="Kluge, Stefan" sort="Kluge, Stefan" uniqKey="Kluge S" first="Stefan" last="Kluge">Stefan Kluge</name><name sortKey="Kluge, Stefan" sort="Kluge, Stefan" uniqKey="Kluge S" first="Stefan" last="Kluge">Stefan Kluge</name><name sortKey="Kluge, Stefan" sort="Kluge, Stefan" uniqKey="Kluge S" first="Stefan" last="Kluge">Stefan Kluge</name><name sortKey="Marx, Gernot" sort="Marx, Gernot" uniqKey="Marx G" first="Gernot" last="Marx">Gernot Marx</name><name sortKey="Marx, Gernot" sort="Marx, Gernot" uniqKey="Marx G" first="Gernot" last="Marx">Gernot Marx</name><name sortKey="Marx, Gernot" sort="Marx, Gernot" uniqKey="Marx G" first="Gernot" last="Marx">Gernot Marx</name><name sortKey="Weber Carstens, Steffen" sort="Weber Carstens, Steffen" uniqKey="Weber Carstens S" first="Steffen" last="Weber-Carstens">Steffen Weber-Carstens</name><name sortKey="Weber Carstens, Steffen" sort="Weber Carstens, Steffen" uniqKey="Weber Carstens S" first="Steffen" last="Weber-Carstens">Steffen Weber-Carstens</name><name sortKey="Welte, Tobias" sort="Welte, Tobias" uniqKey="Welte T" first="Tobias" last="Welte">Tobias Welte</name><name sortKey="Welte, Tobias" sort="Welte, Tobias" uniqKey="Welte T" first="Tobias" last="Welte">Tobias Welte</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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