International variation in the management of severe COVID-19 patients

被引：49

作者：

Azoulay, Elie ^{[1
]}

de Waele, Jan ^{[2
]}

Ferrer, Ricard ^{[3
,4
]}

Staudinger, Thomas ^{[5
]}

Borkowska, Marta ^{[2
]}

Povoa, Pedro ^{[6
]}

Iliopoulou, Katerina ^{[7
]}

Artigas, Antonio ^{[8
]}

Schaller, Stefan J. ^{[9
,10
,11
,12
]}

Shankar-Hari, Manu ^{[13
]}

Pellegrini, Mariangela ^{[14
,15
,16
,17
,18
]}

Darmon, Michael ^{[1
]}

Kesecioglu, Jozef ^{[19
]}

Cecconi, Maurizio ^{[20
]}

机构：

[1] Paris Univ, Hop St Louis, St Louis Hosp, AP HP,Med Intens & Reanimat Dept, 1 Ave Claude Vellefaux, F-75010 Paris, France

[2] Ghent Univ Hosp, Dept Crit Care Med, NL-9000 Ghent, Netherlands

[3] Inst Invest Vail dHebron, Shock Organ Dysfunct & Resuscitat Res Grp SODIR, Barcelona, Spain

[4] Hosp Univ Vall dHebron, Ctr Invest Biomed Red CIBER Enfermedades Resp, Dept Med Intens, Barcelona, Spain

[5] Med Univ Vienna, Vienna Gen Hosp, Dept Med 1, Intens Care Unit, Vienna, Austria

[6] Univ Nova Lisboa, Hosp Sao Francisco Xavier, NOVA Med Sch, CHRC,Unidade Cuidados Intens Polivalente,CHLO, Estr Forte Alto Do Duque, P-1449005 Lisbon, Portugal

[7] ICU Nurse Manager Gen Mil Hosp, Hellen Army, Athens, Greece

[8] Autonomous Univ Barcelona, Sabadell Hosp, Crit Care Ctr, Univ Inst Parc Tauli, Barcelona, Spain

[9] Charite Univ Med Berlin, Berlin, Germany

[10] Free Univ Berlin, Berlin, Germany

[11] Humboldt Univ, Berlin, Germany

[12] Berlin Inst Hlth, Dept Anesthesiol & Surg Intens Care, Berlin, Germany

[13] Kings Coll London, Guys & St Thomas NHS Fdn Trust, Sch Immunol & Microbial Sci, ICU Support Off,St Thomas Hosp, London, England

[14] Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Surg Sci, Gothenburg, Sweden

[15] Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Cent Intens Care Unit, Gothenburg, Sweden

[16] Univ Gothenburg, Sahlgrenska Acad, Dept Anesthesia Operat & Intens Care, Gothenburg, Sweden

[17] Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Gothenburg, Sweden

[18] Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Anesthesiol & Intens Care Med, Gothenburg, Sweden

[19] Univ Utrecht, Univ Med Ctr Utrecht, Div Anesthesiol Intens Care & Emergency Med, Dept Intens Care Med, Utrecht, Netherlands

[20] Humanitas Univ, Humanitas Clin & Res Ctr, Milan, Italy

来源：

CRITICAL CARE | 2020年 / 24卷 / 01期

关键词：

Coronavirus; Acute respiratory distress syndrome; Viral infection; Remdesivir;

D O I：

10.1186/s13054-020-03194-w

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background There is little evidence to support the management of severe COVID-19 patients. Methods To document this variation in practices, we performed an online survey (April 30-May 25, 2020) on behalf of the European Society of Intensive Care Medicine (ESICM). A case vignette was sent to ESICM members. Questions investigated practices for a previously healthy 39-year-old patient presenting with severe hypoxemia from COVID-19 infection. Results A total of 1132 ICU specialists (response rate 20%) from 85 countries (12 regions) responded to the survey. The survey provides information on the heterogeneity in patient's management, more particularly regarding the timing of ICU admission, the first line oxygenation strategy, optimization of management, and ventilatory settings in case of refractory hypoxemia. Practices related to antibacterial, antiviral, and anti-inflammatory therapies are also investigated. Conclusions There are important practice variations in the management of severe COVID-19 patients, including differences at regional and individual levels. Large outcome studies based on multinational registries are warranted.

引用

页数：7

共 7 条

[1]

Alhazzani W, 2020, CRIT CARE MED, V48, pE440, DOI [10.1097/CCM.0000000000004363, 10.1007/s00134-020-06022-5]

[2] Managing ICU surge during the COVID-19 crisis: rapid guidelines [J].

Aziz, Shadman ;

Arabi, Yaseen M. ;

Alhazzani, Waleed ;

Evans, Laura ;

Citerio, Giuseppe ;

Fischkoff, Katherine ;

Salluh, Jorge ;

Meyfroidt, Geert ;

Alshamsi, Fayez ;

Oczkowski, Simon ;

Azoulay, Elie ;

Price, Amy ;

Burry, Lisa ;

Dzierba, Amy ;

Benintende, Andrew ;

Morgan, Jill ;

Grasselli, Giacomo ;

Rhodes, Andrew ;

Moller, Morten H. ;

Chu, Larry ;

Schwedhelm, Shelly ;

Lowe, John J. ;

Bin, Du ;

Christian, Michael D. .

INTENSIVE CARE MEDICINE, 2020, 46 (07) :1303-1325

[3] Clinical phenotypes of critically ill COVID-19 patients [J].

Azoulay, Elie ;

Zafrani, Lara ;

Mirouse, Adrien ;

Lengline, Etienne ;

Darmon, Michael ;

Chevret, Sylvie .

INTENSIVE CARE MEDICINE, 2020, 46 (08) :1651-1652

[4] A Bold Response to the COVID-19 Pandemic Medical Students, National Service, and Public Health [J].

Bauchner, Howard ;

Sharfstein, Joshua .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2020, 323 (18) :1790-1791

[5] Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients With COVID-19 (April 2020) [J].

Bhimraj, Adarsh ;

Morgan, Rebecca L. ;

Shumaker, Amy Hirsch ;

Lavergne, Valery ;

Baden, Lindsey ;

Cheng, Vincent Chi-Chung ;

Edwards, Kathryn M. ;

Gandhi, Rajesh ;

Muller, William J. ;

O'Horo, John C. ;

Shoham, Shmuel ;

Murad, M. Hassan ;

Mustafa, Reem A. ;

Sultan, Shahnaz ;

Falck-Ytter, Yngve .

CLINICAL INFECTIOUS DISEASES, 2020, 78 (07) :e83-e102

[6] Prothrombotic phenotype in COVID-19 severe patients [J].

Helms, Julie ;

Severac, Francois ;

Merdji, Hamid ;

Angles-Cano, Eduardo ;

Meziani, Ferhat .

INTENSIVE CARE MEDICINE, 2020, 46 (07) :1502-1503

[7]

Sprung CL, 2019, JAMA-J AM MED ASSOC, V322, P1692, DOI 10.1001/jama.2019.14608

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