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

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

Francesco Alessandri, Giancarlo Ceccarelli, Federico Bilotta, Francesco Pugliese, Franco Ruberto, Fabio Araimo, Carmela Imperiale

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.

2020

clinical management, COVID-19 patients, “on the field” experience

DOI: 10.1055/s-0040-1713016

Journal of Neuroanaesthesiology and Critical Care

Thieme Publishers

Anesthesiology