COVID-19 危重病:数据驱动的回顾。

IF 15.1 1区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Annual review of medicine Pub Date : 2022-01-27 Epub Date: 2021-09-14 DOI:10.1146/annurev-med-042420-110629
Jennifer C Ginestra, Oscar J L Mitchell, George L Anesi, Jason D Christie
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引用次数: 0

摘要

冠状病毒病 2019(COVID-19)大流行给重症监护医学带来了前所未有的挑战,包括对重症监护病房(ICU)资源的极度需求和对新型疾病认识的快速发展。多达三分之一的 COVID-19 住院患者会出现危重症。COVID-19 重症患者最常见的器官衰竭形式是急性低氧血症性呼吸衰竭,四分之三的重症监护室患者临床表现为急性呼吸窘迫综合征(ARDS)。无创呼吸支持模式具有减少插管的潜力,因此使用频率越来越高。确定最佳插管患者选择和插管时机仍是一项挑战。对 COVID-19 机械通气患者的管理与非 COVID-19 ARDS 患者基本一致。器官衰竭很常见,预示着预后不良。在大流行期间,死亡率有所改善,这可能是由于对疾病的熟悉程度不断提高、数据驱动的药物治疗以及对循证重症护理的坚持。
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COVID-19 Critical Illness: A Data-Driven Review.

The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges in critical care medicine, including extreme demand for intensive care unit (ICU) resources and rapidly evolving understanding of a novel disease. Up to one-third of hospitalized patients with COVID-19 experience critical illness. The most common form of organ failure in COVID-19 critical illness is acute hypoxemic respiratory failure, which clinically presents as acute respiratory distress syndrome (ARDS) in three-quarters of ICU patients. Noninvasive respiratory support modalities are being used with increasing frequency given their potential to reduce the need for intubation. Determining optimal patient selection for and timing of intubation remains a challenge. Management of mechanically ventilated patients with COVID-19 largely mirrors that of non-COVID-19 ARDS. Organ failure is common and portends a poor prognosis. Mortality rates have improved over the course of the pandemic, likely owing to increasing disease familiarity, data-driven pharmacologics, and improved adherence to evidence-based critical care.

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来源期刊
Annual review of medicine
Annual review of medicine 医学-医学:内科
CiteScore
24.90
自引率
0.00%
发文量
58
期刊介绍: The Annual Review of Medicine, which has been published since 1950, focuses on important advancements in diverse areas of medicine. These include AIDS/HIV, cardiology, clinical pharmacology, dermatology, endocrinology/metabolism, gastroenterology, genetics, immunology, infectious disease, neurology, oncology/hematology, pediatrics, psychiatry, pulmonology, reproductive medicine, and surgery. The journal's current volume has transitioned from a gated access model to an open access model through the Annual Reviews' Subscribe to Open program. All articles published in the journal are now available under a CC BY license.
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