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COVID-19 patient in the hospital

Coronavirus Disease 2019 (COVID-19) is currently a global problem. Patients require specific care from initial treatment in emergency departments. Many patients with extensive bilateral pneumonia require hospitalization in the intensive care unit and are dependent on high-flow oxygen therapy. In some of them, despite all treatment, lung disease progresses to the form of acute respiratory distress syndrome with the need to be connected to mechanical lung ventilation. Adequate blood gas exchange often cannot be achieved by a protective setting of mechanical ventilation. Therefore, the physician must use the prone position and, in the most severe cases, also consider the extracorporeal membrane oxygenation support. The algorithm is divided into two parts, and the participant can decide whether he wants to take care of the patient with COVID-19 during emergency admission or play the role of an intensive care physician.

Olga Smékalová, Kateřina Hadrabová, Jan Beneš

Coronavirus Disease 2019 (COVID-19) is currently a global problem. Patients require specific care from initial treatment in emergency departments. Many patients with extensive bilateral pneumonia require hospitalization in the intensive care unit and are dependent on high-flow oxygen therapy. In some of them, despite all treatment, lung disease progresses to the form of acute respiratory distress syndrome with the need to be connected to mechanical lung ventilation. Adequate blood gas exchange often cannot be achieved by a protective setting of mechanical ventilation. Therefore, the physician must use the prone position and, in the most severe cases, also consider the extracorporeal membrane oxygenation support. The algorithm is divided into two parts, and the participant can decide whether he wants to take care of the patient with COVID-19 during emergency admission or play the role of an intensive care physician.

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Keywords: covid-19, intensive care, respiratory infection, ventilation

Review

The disease caused by SARS-CoV-2 (COVID-19) is a highly topical issue of a pandemic nature, which leads to a great burden on the health system worldwide, and in severe forms to a significant increase in morbidity and mortality. COVID-19-based acute respiratory distress syndrome (ARDS) usually leads to a life-threatening respiratory gas exchange disorder that cannot be resolved with the protective setting of conventional artificial lung ventilation or pronation position and initiation of extracorporeal membrane oxygenation (ECMO) support should be considered. Managing the care of patients with COVID-19 on their arrival at the hospital, e.g., through the emergency room (ER) and hospitalization in the intensive care unit (ICU), is currently a key part of many health professionals’ workload not only in the Czech Republic. The presented algorithm is a clear guide on leading the management of COVID-19 patients in two levels of severity, wherein two branches logically describe health care from the ER to the ICU.

created: 5. 6. 2021 | last modified on: 28. 9. 2021


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