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1.
Chest ; 160(4): e371-e372, 2021 10.
Artículo en Inglés | MEDLINE | ID: covidwho-1821182
4.
Chest ; 158(4): 1499-1514, 2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-805272

RESUMEN

BACKGROUND: The role of tracheostomy during the coronavirus disease 2019 (COVID-19) pandemic remains unknown. The goal of this consensus statement is to examine the current evidence for performing tracheostomy in patients with respiratory failure from COVID-19 and offer guidance to physicians on the preparation, timing, and technique while minimizing the risk of infection to health care workers (HCWs). METHODS: A panel including intensivists and interventional pulmonologists from three professional societies representing 13 institutions with experience in managing patients with COVID-19 across a spectrum of health-care environments developed key clinical questions addressing specific topics on tracheostomy in COVID-19. A systematic review of the literature and an established modified Delphi consensus methodology were applied to provide a reliable evidence-based consensus statement and expert panel report. RESULTS: Eight key questions, corresponding to 14 decision points, were rated by the panel. The results were aggregated, resulting in eight main recommendations and five additional remarks intended to guide health-care providers in the decision-making process pertinent to tracheostomy in patients with COVID-19-related respiratory failure. CONCLUSION: This panel suggests performing tracheostomy in patients expected to require prolonged mechanical ventilation. A specific timing of tracheostomy cannot be recommended. There is no evidence for routine repeat reverse transcription polymerase chain reaction testing in patients with confirmed COVID-19 evaluated for tracheostomy. To reduce the risk of infection in HCWs, we recommend performing the procedure using techniques that minimize aerosolization while wearing enhanced personal protective equipment. The recommendations presented in this statement may change as more experience is gained during this pandemic.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/terapia , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Neumonía Viral/terapia , Insuficiencia Respiratoria/terapia , Traqueostomía , COVID-19 , Protocolos Clínicos , Consenso , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/transmisión , Humanos , Pandemias , Selección de Paciente , Neumonía Viral/complicaciones , Neumonía Viral/transmisión , Insuficiencia Respiratoria/virología , SARS-CoV-2 , Sociedades Médicas
5.
Drugs Context ; 92020.
Artículo en Inglés | MEDLINE | ID: covidwho-200555

RESUMEN

Chloroquine and closely related structural analogs, employed initially for the treatment of malaria, are now gaining worldwide attention due to the rapidly spreading pandemic caused by severe acute respiratory syndrome-coronavirus-2, named coronavirus disease (COVID) of 2019 (COVID-19). Although much of this attention has a mechanistic basis, the hard efficacy data for chloroquine/hydroxychloroquine in the management of the clinical syndrome of COVID-19 have been limited thus far. This review aims to present the available in vitro and clinical data for the role of chloroquine/hydroxychloroquine in COVID-19 and attempts to put them into perspective, especially in relation to the different risks/benefits particular to each patient who may require treatment.

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