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Guidelines Developed for COVID-19 Patients in ICU

54 statements issued on infection control, diagnosis, hemodynamic support, ventilator support, therapy

man on respirator

WEDNESDAY, April 8, 2020 (HealthDay News) -- In guidelines issued by the international Surviving Sepsis Campaign initiative, published in Critical Care Medicine and Intensive Care Medicine, recommendations are presented for the management of novel coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU).

Waleed Alhazzani, M.B.B.S., from McMaster University in Hamilton, Ontario, Canada, and colleagues formed a panel of 36 experts from 12 countries to develop guidance for management of COVID-19 in the ICU. The recommendations address infection control, laboratory diagnosis and specimens, hemodynamic support, ventilator support, and COVID-19 therapy.

The researchers issued 54 statements, including four best practice statements, nine strong recommendations, and 35 weak recommendations. For infection control and testing, fitted respirator masks are recommended in addition to other personal protective equipment for health care workers performing aerosol-generating procedures on patients with COVID-19. In addition, these procedures should be performed in a negative pressure room. To minimize the number of attempts and risk for transmission, endotracheal intubation should be performed by the health care worker who is most experienced with airway management. Close monitoring is recommended for worsening of respiratory status in patients receiving noninvasive positive pressure ventilation or a high-flow nasal cannula; early intubation should be performed in a controlled setting if worsening occurs.

"Usually, it takes a year or two to develop large clinical practice guidelines such as these ones," Alhazzani said in a statement. "Given the urgency and the huge need for these guidelines, we assembled the team, searched the literature, summarized the evidence, and formulated recommendations within 18 days."

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