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Evidence-Based Management of the Critically Ill Adult With SARS-CoV-2 Infection.
Chivukula, Raghu R; Maley, Jason H; Dudzinski, David M; Hibbert, Kathryn; Hardin, C Corey.
  • Chivukula RR; Division of Pulmonary and Critical Care Medicine, Department of Medicine, 2348Massachusetts General Hospital, Boston, MA, USA.
  • Maley JH; Whitehead Institute for Biomedical Research, Cambridge, MA, USA.
  • Dudzinski DM; Division of Pulmonary and Critical Care Medicine, Department of Medicine, 2348Massachusetts General Hospital, Boston, MA, USA.
  • Hibbert K; Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, 2348Massachusetts General Hospital, Boston, MA, USA.
  • Hardin CC; Cardiac Intensive Care Unit, Division of Cardiology, Department of Medicine, Massachusetts General, Hospital, Boston, MA, USA.
J Intensive Care Med ; 36(1): 18-41, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-894960
ABSTRACT
Human infection by the novel viral pathogen SARS-CoV-2 results in a clinical syndrome termed Coronavirus Disease 2019 (COVID-19). Although the majority of COVID-19 cases are self-limiting, a substantial minority of patients develop disease severe enough to require intensive care. Features of critical illness associated with COVID-19 include hypoxemic respiratory failure, acute respiratory distress syndrome (ARDS), shock, and multiple organ dysfunction syndrome (MODS). In most (but not all) respects critically ill patients with COVID-19 resemble critically ill patients with ARDS due to other causes and are optimally managed with standard, evidence-based critical care protocols. However, there is naturally an intense interest in developing specific therapies for severe COVID-19. Here we synthesize the rapidly expanding literature around the pathophysiology, clinical presentation, and management of COVID-19 with a focus on those points most relevant for intensivists tasked with caring for these patients. We specifically highlight evidence-based approaches that we believe should guide the identification, triage, respiratory support, and general ICU care of critically ill patients infected with SARS-CoV-2. In addition, in light of the pressing need and growing enthusiasm for targeted COVID-19 therapies, we review the biological basis, plausibility, and clinical evidence underlying these novel treatment approaches.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Illness / Critical Care / COVID-19 Type of study: Prognostic study Topics: Long Covid Limits: Adult / Humans Language: English Journal: J Intensive Care Med Journal subject: Critical Care Year: 2021 Document Type: Article Affiliation country: 0885066620969132

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Illness / Critical Care / COVID-19 Type of study: Prognostic study Topics: Long Covid Limits: Adult / Humans Language: English Journal: J Intensive Care Med Journal subject: Critical Care Year: 2021 Document Type: Article Affiliation country: 0885066620969132