Successful management of seven cases of critical COVID-19 with early noninvasive-invasive sequential ventilation algorithm and bundle pharmacotherapy

• 作者: Baojun Yu Di Ren Jinxiu Li Mian Peng Ronglin Chen Weixiong Zhong Xi Meng Xueyan Liu Yansi Lyu Yongfeng Liu
• 来源期刊: 医学前沿
• 年，卷（期）: 2020,（5）
• 所属期刊栏目: Case Report
• 页码范围: 674-680
• 页数: 7页
• 语种: 英文

摘要

We report the clinical and laboratory findings and successful management of seven patients with critical coronavirus disease 2019 (COVID-19) requiring mechanical ventilation (MV).The patients were diagnosed based on epidemiological history,clinical manifestations,and nucleic acid testing.Upon diagnosis with COVID-19 of critical severity,the patients were admitted to the intensive care unit,where they received early noninvasive-invasive sequential ventilation,early prone positioning,and bundle pharmacotherapy regimen,which consists of antiviral,anti-inflammation,immune-enhancing,and complication-prophylaxis medicines.The patients presented fever (n =7,100％),dry cough (n =3,42.9％),weakness (n =2,28.6％),chest tightness (n =1,14.3％),and/or muscle pain (n =1,14.3％).All patients had normal or lower than normal white blood cell count/lymphocyte count,and chest computed tomography scans showed bilateral patchy shadows or ground glass opacity in the lungs.Nucleic acid testing confirmed COVID-19 in all seven patients.The median MV duration and intensive care unit stay were 9.9 days (interquartile range,6.5-14.6 days;range,5-17 days) and 12.9 days (interquartile range,9.7-17.6 days;range,7-19 days),respectively.All seven patients were extubated,weaned off MV,transferred to the common ward,and discharged as of the writing of this report.Thus,we concluded that good outcomes for patients with critical COVID-19 can be achieved with early noninvasive-invasive sequential ventilation and bundle pharmacotherapy.