Open Access
CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2020; 07(02): 054-061
DOI: 10.1055/s-0040-1713016
Review Article

Clinical Management of Critical COVID-19 Patients: Insights from the Literature and “On the Field” Experience

Francesco Alessandri*
1   Department of Anesthesia and Intensive Care Medicine, “Sapienza” University of Rome, Policlinico Umberto I, Rome, Italy
,
Federico Bilotta*
1   Department of Anesthesia and Intensive Care Medicine, “Sapienza” University of Rome, Policlinico Umberto I, Rome, Italy
,
Giancarlo Ceccarelli
2   Department of Public Health and Infectious Diseases, University of Rome Sapienza, Policlinico Umberto I Rome, Rome, Italy
,
Franco Ruberto
1   Department of Anesthesia and Intensive Care Medicine, “Sapienza” University of Rome, Policlinico Umberto I, Rome, Italy
,
Fabio Araimo
1   Department of Anesthesia and Intensive Care Medicine, “Sapienza” University of Rome, Policlinico Umberto I, Rome, Italy
,
Carmela Imperiale
1   Department of Anesthesia and Intensive Care Medicine, “Sapienza” University of Rome, Policlinico Umberto I, Rome, Italy
,
Francesco Pugliese
1   Department of Anesthesia and Intensive Care Medicine, “Sapienza” University of Rome, Policlinico Umberto I, Rome, Italy
,
for the PolU COVID-19 Team› Institutsangaben
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Abstract

The recent outbreak of the coronavirus disease (COVID-19) is a health emergency all over the world. Several health care professionals are currently putting their best efforts to deal with this situation. The aim of this review is to report insights from the literature and “on the field” experience in clinical management of critical COVID-19 patients. Respiratory support varies from high flow nasal cannula (HFNC) to noninvasive and invasive mechanical ventilation, often associated with nitric oxide, prone position, and extracorporeal membrane oxygenation (ECMO). Experienced specialists have to manage the airways minimizing any contamination and virus spread. The hemodynamic management of critical COVID-19 patients requires not only an accurate fluid strategy, but also an appropriate use of vasopressors and inotropes. Various adjuvant treatments have been proposed: antiviral drugs, immunomodulators, anticoagulants, antibiotics, and nutrition.

* These two authors contributed equally to the paper.
Group Information: The Policlinico Umberto I COVID-19 (PoLU COVID-19 Team) Members: Pugliese Francesco, MD, Bilotta Federico, MD, Alessandri Francesco, MD, Ruberto Franco, MD, Araimo Fabio, MD, Imperiale Carmela, MD, Albante Alida, MD, Auricchio Daniela, MD, De Lazzaro Francesco, MD, De Lauri Daniela, MD, Di Santo Carmela, MD, Ianni Stefano, MD, Magnanimi Eugenia, MD, Ratini Fabiola, MD, Sabani Anna, MD, Titi Luca, MD, Vaccaro Paola, MD, Giordano Giovanni, MD, Manganelli Chiara, MD, Mancone Massimo, MD, Bruno Katia, MD, Celli Paola, MD, Consolo Stella, MD, Croce Claudia, MD, Giannetti Lorena, MD, Martelli Sabina, MD, Messina Teresa, MD, Pattelli Elisa, MD, Perrella Serena, MD, Piazzolla Mario, MD, Portieri Monica, MD, Ricci Claudia, MD, Almenrader Nicole, MD, Arzilla Roberto, MD, Delia Emilia, MD, Di Giovanni Claudio, MD, Macrì Carlotta, MD, Marandola Maurizio, MD, Nardecchia Giada, MD, Pacilli Massimo, MD, Pacini Francesca, MD, Tordiglione Paolo, MD




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Artikel online veröffentlicht:
11. Juni 2020

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