Knowledge Entity Modeler Report

Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)

Published: 4/22/2020

By: Denis Gagne

Table of Contents

Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)

Overview

Business Rules

Practitioners

Diagram

Terms

Patients

Diagram

Terms

PPE

Diagram

Terms

Facilities

Diagram

Terms

Labs

Diagram

Terms

Conditions

Diagram

Terms

Observations

Diagram

Terms

Procedures

Diagram

Terms

Medications

Diagram

Terms

Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)

Overview

Source: 

Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)

https://www.ncbi.nlm.nih.gov/pubmed/32222812

 

Members of the panel:

Business Rules

Infection Control and Testing

1 For healthcare workers performing aerosol-generating procedures* on patients with COVID-19 in the ICU, we recommend using fitted respirator masks (N95 respirators, FFP2, or equivalent), as opposed to surgical/medical masks, in addition to other personal protective equipment (i.e., gloves, gown, and eye protection, such as a face shield or safety goggles)

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2 We recommend performing aerosol-generating procedures on ICU patients with COVID-19 in a negative pressure room.

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3 For healthcare workers providing usual care for non-ventilated COVID-19 patients, we suggest using surgical/medical masks, as opposed to respirator masks, in addition to other personal protective equipment (i.e., gloves, gown, and eye protection, such as a face shield or safety goggles).

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4 For healthcare workers who are performing non-aerosol-generating procedures on mechanically ventilated (closed circuit ) patients with COVID-19, we suggest using surgical/medical masks, as opposed to respirator masks, in addition to other personal protective equipment (i.e., gloves, gown, and eye protection, such as a face shield or safety goggles).

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5 For healthcare workers performing endotracheal intubation on patients with COVID-19, we suggest using video-guided laryngoscopy, over direct laryngoscopy, if available.

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6 For COVID-19 patients requiring endotracheal intubation, we recommend that endotracheal intubation be performed by the healthcare worker who is most experienced with airway management in order to minimize the number of attempts and risk of transmission.

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7 

7.1 For intubated and mechanically ventilated adults with suspicion of COVID-19: For diagnostic testing, we suggest obtaining lower respiratory tract samples in preference to upper respiratory tract (nasopharyngeal or oropharyngeal) samples.

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7.2 For intubated and mechanically ventilated adults with suspicion of COVID-19: With regard to lower respiratory samples, we suggest obtaining endotracheal aspirates in preference to bronchial wash or bronchoalveolar lavage samples.

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Hemodynamics

1 In adults with COVID-19 and shock, we suggest using dynamic parameters skin temperature, capillary refilling time, and/or serum lactate measurement over static parameters in order to assess fluid responsiveness.

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2 For the acute resuscitation of adults with COVID-19 and shock, we suggest using a conservative over a liberal fluid strategy.

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3 For the acute resuscitation of adults with COVID-19 and shock, we recommend using crystalloids over colloids.

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4 For the acute resuscitation of adults with COVID-19 and shock, we suggest using buffered/balanced crystalloids over unbalanced crystalloids.

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5 For the acute resuscitation of adults with COVID-19 and shock, we recommend against using hydroxyethyl starches.

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6 For the acute resuscitation of adults with COVID-19 and shock, we suggest against using gelatins.

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7 For the acute resuscitation of adults with COVID-19 and shock, we suggest against using dextrans.

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8 For the acute resuscitation of adults with COVID-19 and shock, we suggest against the routine use of albumin for initial resuscitation.

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9 For adults with COVID-19 and shock, we suggest using norepinephrine as the first-line vasoactive agent, over other agents.

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10 If norepinephrine is not available, we suggest using either vasopressin or epinephrine as the firstline vasoactive agent, over other vasoactive agents, for adults with COVID-19 and shock.

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11 For adults with COVID-19 and shock, we recommend against using dopamine if norepinephrine is available.

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12 For adults with COVID-19 and shock, we suggest adding vasopressin as a second-line agent, over titrating norepinephrine dose, if target mean arterial pressure (MAP) cannot be achieved by norepinephrine alone.

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13 For adults with COVID-19 and shock, we suggest titrating vasoactive agents to target a MAP of 60-65 mmHg, rather than higher MAP targets.

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14 For adults with COVID-19 and shock with evidence of cardiac dysfunction and persistent hypoperfusion despite fluid resuscitation and norepinephrine, we suggest adding dobutamine, over increasing norepinephrine dose.

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15 For adults with COVID-19 and refractory shock, we suggest using low-dose corticosteroid therapy ("shock-reversal"), over no corticosteroid.
Remark: A typical corticosteroid regimen in septic shock is intravenous hydrocortisone 200 mg per day administered either as an infusion or intermittent doses.

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Ventilation

1 In adults with COVID-19, we suggest starting supplemental oxygen if the peripheral oxygen saturation (Spo2) is < 92%, and recommend starting supplemental oxygen if Spo2 is < 90%

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2 In adults with COVID-19 and acute hypoxemic respiratory failure on oxygen, we recommend that Spo2 be maintained no higher than 96%.

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3 For adults with COVID-19 and acute hypoxemic respiratory failure despite conventional oxygen therapy, we suggest using HFNC over conventional oxygen therapy.

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4 In adults with COVID-19 and acute hypoxemic respiratory failure, we suggest using HFNC over NIPPV.

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5 In adults with COVID-19 and acute hypoxemic respiratory failure, if HFNC is not available and there is no urgent indication for endotracheal intubation, we suggest a trial of NIPPV with close monitoring and short-interval assessment for worsening of respiratory failure.

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6 We were not able to make a recommendation regarding the use of helmet NIPPV compared with mask NIPPV. It is an option, but we are not certain about its safety or efficacy in COVID-19.

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7 

7.1 In adults with COVID-19 receiving NIPPV or HFNC, we recommend close monitoring for worsening of respiratory status, and early intubation in a controlled setting if worsening occurs.

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7.2 In mechanically ventilated adults with COVID-19 and ARDS, we recommend using low tidal volume (Vt) ventilation (Vt 4-8 mL/kg of predicted body weight), over higher tidal volumes (Vt>8 mL/kg).

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8 For mechanically ventilated adults with COVID-19 and ARDS, we recommend targeting plateau pressures (Pplat) of < 30 cm H2O.

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9 For mechanically ventilated adults with COVID-19 and moderate to severe ARDS, we suggest using a higher PEEP strategy, over a lower PEEP strategy.
Remarks: If using a higher PEEP strategy (i.e., PEEP > 10 cm H2O), clinicians should monitor patients for barotrauma.

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10 For mechanically ventilated adults with COVID-19 and ARDS, we suggest using a conservative fluid strategy over a liberal fluid strategy.

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11 For mechanically ventilated adults with COVID-19 and moderate to severe ARDS, we suggest prone ventilation for 12 to 16 hours, over no prone ventilation.

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12 

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12.1 For mechanically ventilated adults with COVID-19 and moderate to severe ARDS, we suggest using, as needed, intermittent boluses of neuromuscular blocking agents (NMBA), over continuous NMBA infusion, to facilitate protective lung ventilation.

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12.2 In the event of persistent ventilator dyssynchrony, the need for ongoing deep sedation, prone ventilation, or persistently high plateau pressures, we suggest using a continuous NMBA infusion for up to 48 hours.

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13 In mechanically ventilated adults with COVID-19 ARDS, we recommend against the routine use of inhaled nitric oxide.

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14 In mechanically ventilated adults with COVID-19, severe ARDS and hypoxemia despite optimizing ventilation and other rescue strategies, we suggest a trial of inhaled pulmonary vasodilator as a rescue therapy; if no rapid improvement in oxygenation is observed, the treatment should be tapered off.

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15 For mechanically ventilated adults with COVID-19 and hypoxemia despite optimizing ventilation, we suggest using recruitment maneuvers, over not using recruitment maneuvers.

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16 If recruitment maneuvers are used, we recommend against using staircase (incremental PEEP) recruitment maneuvers.

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17 In mechanically ventilated adults with COVID-19 and refractory hypoxemia despite optimizing ventilation, use of rescue therapies, and proning, we suggest using venovenous (VV) ECMO if available, or referring the patient to an ECMO center.
Remark: Due to the resource-intensive nature of ECMO, and the need for experienced centers and healthcare workers, and infrastructure, ECMO should only be considered in carefully selected patients with COVID-19 and severe ARDS.

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Therapy

1 In mechanically ventilated adults with COVID-19 and respiratory failure (without ARDS), we suggest against the routine use of systemic corticosteroids.

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2 In mechanically ventilated adults with COVID-19 and ARDS, we suggest using systemic corticosteroids, over not using corticosteroids.
Remark: The majority of our panel support a weak recommendation (i.e., suggestion) to use steroids in the sickest patients with COVID-19 and ARDS. However, because of the very low-quality evidence, some experts on the panel preferred not to issue a recommendation until higher quality direct evidence is available.

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3 In mechanically ventilated patients with COVID-19 and respiratory failure, we suggest using empiric antimicrobials/antibacterial agents, over no antimicrobials.
Remark: if the treating team initiates empiric antimicrobials, they should assess for de-escalation daily, and re-evaluate the duration of therapy and spectrum of coverage based on the microbiology results and the patient’s clinical status.

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4 For critically ill adults with COVID-19 who develop fever, we suggest using acetaminophen/paracetamol for temperature control, over no treatment.

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5 In critically ill adults with COVID-19, we suggest against the routine use of standard intravenous immunoglobulins (IVIG).

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6 In critically ill adults with COVID-19, we suggest against the routine use of convalescent plasma.

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7 

7.1 In critically ill adults with COVID-19: we suggest against the routine use of lopinavir/ritonavir.

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7.2 There is insufficient evidence to issue a recommendation on the use of other antiviral agents in critically ill adults with COVID-19.

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7.2.1 There is insufficient evidence to issue a recommendation on the use of recombinant rIFNs, alone or in combination with antivirals, in critically ill adults with COVID-19.

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8 There is insufficient evidence to issue a recommendation on the use of chloroquine or hydroxychloroquine in critically ill adults with COVID-19.

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9 There is insufficient evidence to issue a recommendation on the use of tocilizumab in critically ill adults with COVID-19.

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Practitioners

Diagram

Terms

person

Description

A human being regarded as an individual.

Alternatives

persons

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/person

panel

Description

A group of persons selected for some service (such as investigation or arbitration)

Alternatives

we

Relations

Examples

panel of experts

Sources

Merriam-Websterhttps://www.merriam-webster.com/dictionary/panel

clinician

Description

A doctor having direct contact with and responsibility for patients, rather than one involved with theoretical or laboratory studies.

Alternatives

clinicians

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/clinician

personal protective equipment

Description

A protective clothing, helmets, goggles, or other garments or equipment designed to protect the wearer's body from injury or  infection.

Alternatives

PPE

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Personal_protective_equipment

insufficient evidence

Description

Evidence that does not meet the burden of proof

Relations

researcher

Description

person engaged in conducting research, possibly recognized as such by a formal job title

Alternatives

researchers

Relations

Sources

Wikipidiahttps://en.wikipedia.org/wiki/Researcher_(disambiguation)

healthcare worker

Description

A health professional (or healthcare professional) may provide healthcare treatment and advice based on formal training and experience

Alternatives

healthcare workers
healthcare professional
health professional

Relations

Examples

The field includes those who work as a physician, surgeon, nurse, physiotherapist,dentist, midwife, psychologist, psychiatrist, or pharmacist or who perform services in allied health professions.

Sources

Wikipediahttps://en.wikipedia.org/wiki/Health_professional

usual care

Relations

evidence

Description

 Something that furnishes proof 

Relations

Sources

Merriam-Websterhttps://www.merriam-webster.com/dictionary/evidence

recommendation

Description

A suggestion or proposal as to the best course of action, especially one put forward by an authoritative body.

Relations

Notes

The reference uses the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the quality of evidence.

Sources

Oxfordhttps://www.lexico.com/en/definition/recommendation
GRADE: an emerging consensus on rating quality of evidence and strength of recommendationshttps://www.ncbi.nlm.nih.gov/pubmed/32222812

medical procedure

Description

A course of action intended to achieve a result in the delivery of healthcare.

Alternatives

medical procedures

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Medical_procedure

medication

Description

A substance used for medical treatment, especially a medicine or drug.

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/medication

treating team

Relations

strong recommendation

Description

Must do or Must avoid

Relations

Notes

  1. Implications to Patients: Almost all individuals in this situation would want the recommended intervention, and only a small proportion would not want it
  2. Implications to Clinicians: Most individuals should receive the recommended course of action
  3. Implications to Policymakers:Can be adapted as policy in most situations, including the use as performance indicators

best practice statement

Relations

Weak recommendation

Description

Consider doing or Consider avoiding

Relations

Notes

  1. Implications to Patients: The majority of individuals in this situation would want the recommended intervention, but many would not
  2. Implications to Clinicians: Different choices are likely to be appropriate for different patients, and the recommendation should be tailored to the individual patient’s circumstances. Such as patients’, family’s, or substitute decision maker’s values and preferences
  3. Implications to Policymakers:Policies will likely be variable

Patients

Diagram

Terms

adult patient

Description

A person who is fully grown or developed receiving or registered to receive medical treatment.

Relations

adult

Description

A person who is fully grown or developed.

Alternatives

adults

Relations

patient

Description

A person receiving or registered to receive medical treatment.

Alternatives

patients

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/patient

person

Description

A human being regarded as an individual.

Alternatives

persons

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/person

PPE

Diagram

Terms

personal protective equipment

Description

A protective clothing, helmets, goggles, or other garments or equipment designed to protect the wearer's body from injury or  infection.

Alternatives

PPE

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Personal_protective_equipment

gown

Description

A protective garment worn in hospital, either by a staff member during surgery or by a patient.

Alternatives

gowns

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/gown

glove

Description

A covering for the hand worn for protection against cold or dirt and typically having separate parts for each finger and the thumb.

Alternatives

gloves

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/glove

mask

Description

A covering made of fiber or gauze and fitting over the nose and mouth to protect against dust or air pollutants, or made of sterile gauze and worn to prevent infection of the wearer or (in surgery) of the patient.

Alternatives

face mask

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/mask

eye protection

Alternatives

protective eyewear

Relations

respirator mask

Description

A device designed to protect the wearer from inhaling hazardous atmospheres, including fumes, vapours, gases and particulate matter such as dusts and airborne microorganisms.

Alternatives

respirator masks
respirator

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Respirator

surgical/medical mask

Alternatives

surgical/medical masks

Relations

face shield

Description

personal protective equipment to protect the wearer's entire face (or part of it) from hazards such as flying objects and road debris, chemical splashes (in laboratory or industry), or potentially infectious materials (in medical and laboratory environments).

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Face_shield

safety goggles

Description

Forms of protective eyewear that usually enclose or protect the area surrounding the eye in order to prevent particulates, water or chemicals from striking the eyes.

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Goggles

N95 respirator

Description

A particulate-filtering facepiece respirator that meets the N95 standard of the U.S. National Institute for Occupational Safety and Health (NIOSH) air filtration rating, meaning that it filters at least 95% of airborne particles, while not resistant to oil like the P95.

Alternatives

N95 respirators
N95 mask

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/N95_mask

FFP2

Description

European standard EN 143 defines the 'P' classes of particle filters that can be attached to a face mask, and European standard EN 149 defines the following classes of "filtering half masks" or "filtering face pieces" (FFP), that is respirators that are entirely or substantially constructed of filtering material FPP2 Filters at least 94% of airborne particles.

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Respirator#FFP2

Facilities

Diagram

Terms

patient

Description

A person receiving or registered to receive medical treatment.

Alternatives

patients

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/patient

patient location

Relations

location

Description

A particular place or position.

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/location

intensive care unit

Description

A department of a hospital in which patients who are dangerously ill are kept under constant observation.

Alternatives

ICU

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/intensive_care_unit

negative pressure room

Description

An isolation technique used in hospitals and medical centers to prevent cross-contamination from room to room. It includes a ventilation that generates "negative pressure" (pressure lower than of the surroundings) to allow air to flow into the isolation room but not escape from the room, as air will naturally flow from areas with higher pressure to areas with lower pressure, thereby preventing contaminated air from escaping the room.

Relations

Sources

Wikipefdiahttps://en.wikipedia.org/wiki/Negative_room_pressure

mechanically ventilated patient with COVID-19

Alternatives

mechanically ventilated patients with COVID-19

Relations

Labs

Diagram

Terms

laboratory specimen

Description

A biological specimen taken by sampling, that is, gathered matter of a medical patient's tissue, fluid, or other material derived from the patient used for laboratory analysis to assist differential diagnosis or staging of a disease process.

Relations

Examples

Common examples include throat swabs, sputum, urine, blood, surgical drain fluids, and tissue biopsies

Sources

Wikipediahttps://en.wikipedia.org/wiki/Laboratory_specimen

specimen

Description

sample for medical testing, especially of urine.

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/specimen

respiratory tract sample

Alternatives

respiratory tract samples

Relations

sample

Description

A small part or quantity intended to show what the whole is like.

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/sample

lower respiratory sample

Alternatives

lower respiratory samples

Relations

upper respiratory tract sample

Alternatives

upper respiratory tract (nasopharyngeal or oropharyngeal) samples

Relations

endotracheal aspirate

Alternatives

endotracheal aspirates

Relations

bronchial wash

Relations

bronchoalveolar lavage sample

Alternatives

bronchoalveolar lavage samples

Relations

nasopharyngeal sample

Alternatives

nasopharyngeal

Relations

oropharyngeal sample

Alternatives

oropharyngeal

Relations

Conditions

Diagram

Terms

adult patient

Description

A person who is fully grown or developed receiving or registered to receive medical treatment.

Relations

cardiovascular disease

Description

A class of diseases that involve the heart or blood vessels

Alternatives

CVD

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Cardiovascular_disease

shock

Description

Is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Shock_(circulatory)

barotrauma

Description

Is physical damage to body tissues caused by a difference in pressure between a gas space inside, or in contact with, the body, and the surrounding gas or fluid.

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Barotrauma

respiratory failure

Relations

hypoxemia

Description

An abnormally low level of oxygen in the blood

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Hypoxemia

cardiac dysfunction

Relations

persistent shock

Relations

refractory shock

Relations

septic shock

Relations

complication of mechanical ventilation

Relations

adult respiratory distress syndrome

Alternatives

ARDS

Relations

acute hypoxemic respiratory failure

Relations

persistent hypoperfusion

Relations

moderate to severe adult respiratory distress syndrome

Alternatives

moderate to severe ARDS

Relations

acute hypoxemic respiratory failure on oxygen

Relations

severe adult respiratory distress syndrome

Alternatives

severe ARDS

Relations

adult patient

Description

A person who is fully grown or developed receiving or registered to receive medical treatment.

Relations

COVID-19

Relations

suspicion of COVID-19

Relations

non-ventilated

Alternatives

non-ventilated COVID-19 patients

Relations

ventilation

Description

The supply of air to the lungs, especially by artificial means.

Alternatives

Vt
Ventilated

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/ventilation

critically ill

Alternatives

critically ill adults with COVID-19

Relations

worsening

Relations

risk of transmission

Relations

Observations

Diagram

Terms

observation

Relations

oxygenation

Description

Supply, treat, charge, or enrich with oxygen.

Alternatives

oxygenate

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/oxygenate

ventilator

Description

An appliance for artificial respiration; a respirator.

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/ventilator

body weight

Description

Refers to a person's mass or weight. Body weight is measured in kilograms, a measure of mass, throughout the world, although in some countries such as the United States it is measured in pounds, or as in the United Kingdom, stones and pounds. Most hospitals, even in the United States, now use kilograms for calculations, but use kilograms and pounds together for other purposes.

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Human_body_weight

mean arterial pressure

Description

Is an average blood pressure in an individual during a single cardiac cycle.

Alternatives

MAP
mean arterial pressure (MAP)

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Mean_arterial_pressure

fever

Description

An abnormally high body temperature, usually accompanied by shivering, headache, and in severe instances, delirium.

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/fever

peripheral oxygen saturation

Alternatives

Spo2

Relations

rapid improvement in oxygenation

Relations

respiratory status

Relations

plateau pressure

Alternatives

Pplat
plateau pressures

Relations

persistent ventilator dyssynchrony

Relations

persistently high plateau pressure

Alternatives

persistently high plateau pressures

Relations

Procedures

Diagram

Terms

usual care

Relations

short-interval assessment

Relations

infusion

Description

The slow injection of a substance into a vein or tissue.

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/infusion

medical procedure

Description

A course of action intended to achieve a result in the delivery of healthcare.

Alternatives

medical procedures

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Medical_procedure

temperature control

Relations

close monitoring

Relations

laboratory specimen

Description

A biological specimen taken by sampling, that is, gathered matter of a medical patient's tissue, fluid, or other material derived from the patient used for laboratory analysis to assist differential diagnosis or staging of a disease process.

Relations

Examples

Common examples include throat swabs, sputum, urine, blood, surgical drain fluids, and tissue biopsies

Sources

Wikipediahttps://en.wikipedia.org/wiki/Laboratory_specimen

diagnostic testing

Relations

healthcare worker

Description

A health professional (or healthcare professional) may provide healthcare treatment and advice based on formal training and experience

Alternatives

healthcare workers
healthcare professional
health professional

Relations

Examples

The field includes those who work as a physician, surgeon, nurse, physiotherapist,dentist, midwife, psychologist, psychiatrist, or pharmacist or who perform services in allied health professions.

Sources

Wikipediahttps://en.wikipedia.org/wiki/Health_professional

titrate

Description

Continuously measure and adjust the balance of (a physiological function or drug dosage)

Alternatives

titrating

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/titrate

intubation

Description

The insertion of a tube into a patient's body, especially that of an artificial ventilation tube into the trachea.

Alternatives

intubated

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/intubation

laryngoscopy

Description

Is endoscopy of the larynx, a part of the throat. It is a medical procedure that is used to obtain a view, for example, of the vocal folds and the glottis. Laryngoscopy may be performed to facilitate tracheal intubation during general anaesthesia or cardiopulmonary resuscitation or for surgical procedures on the larynx or other parts of the upper tracheobronchial tree.

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Laryngoscopy

non-aerosol-generating procedure

Alternatives

non-aerosol-generating procedures

Relations

aerosol-generating procedure

Alternatives

aerosol-generating procedures

Relations

endotracheal intubation

Relations

early intubation

Relations

airway management

Description

Includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. This ensures an open pathway for gas exchange between a patient's lungs and the atmosphere. This is accomplished by either clearing a previously obstructed airway; or by preventing airway obstruction in cases such as anaphylaxis, the obtunded patient, or medical sedation. Airway obstruction can be caused by the tongue, foreign objects, the tissues of the airway itself, and bodily fluids such as blood and gastric contents (aspiration).

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Airway_management

video-guided laryngoscopy

Relations

direct laryngoscopy

Relations

obtaining lower respiratory tract sample

Alternatives

obtaining lower respiratory tract samples

Relations

serum lactate measurement

Relations

rescue therapy

Description

A form of therapy given after an ailment does not respond to standard therapy. The most common diseases that require salvage therapy are HIV and various cancers. The term is not clearly defined; it is used both to mean a second attempt and a final attempt. Salvage therapy drugs or drug combinations have, in general, much more severe side effects than the standard line of therapy. This is often true of a drug of last resort.

Alternatives

rescue therapies
rescue strategy
salvage therapy

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Salvage_therapy

fluid strategy

Relations

ongoing deep sedation

Relations

ventilation

Description

The supply of air to the lungs, especially by artificial means.

Alternatives

Vt
Ventilated

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/ventilation

oxygenation

Description

Supply, treat, charge, or enrich with oxygen.

Alternatives

oxygenate

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/oxygenate

extracorporeal membrane oxygenation

Description

An extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life. The technology for ECMO is largely derived from cardiopulmonary bypass, which provides shorter-term support with arrested native circulation.

Alternatives

ECMO
extracorporeal life support
ECLS

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygenation

extracorporeal

Description

medical procedure which is performed outside the body.

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Extracorporeal

recruitment maneuver

Alternatives

recruitment maneuvers

Relations

assess fluid responsiveness

Relations

fluid resuscitation

Relations

liberal fluid strategy

Relations

conservative fluid strategy

Alternatives

conservative

Relations

non-invasive ventilation

Relations

invasive ventilation

Relations

monitoring for worsening of respiratory status

Relations

conventional oxygen therapy

Relations

supplemental oxygen

Relations

high flow nasal cannula

Alternatives

HFNC

Relations

venovenous (VV) extracorporeal membrane oxygenation

Alternatives

venovenous (VV) ECMO

Relations

dynamic parameters skin temperature

Relations

capillary refilling time

Relations

static parameter

Alternatives

static parameters

Relations

resuscitation

Description

The action or process of reviving someone from unconsciousness or apparent death.

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/resuscitation

mechanical ventilation

Alternatives

mechanically ventilated

Relations

acute resuscitation

Relations

initial resuscitation

Relations

positive end-expiratory pressure strategy

Description

The pressure in the lungs (alveolar pressure) above atmospheric pressure (the pressure outside of the body) that exists at the end of expiration

Alternatives

PEEP strategy

Relations

Sources

Wikipediahttps://en.wikipedia.org/wiki/Positive_end-expiratory_pressure

noninvasive positive pressure ventilation

Alternatives

NIPPV

Relations

helmet noninvasive positive pressure ventilation

Alternatives

helmet NIPPV

Relations

mask noninvasive positive pressure ventilation

Alternatives

mask NIPPV

Relations

protective lung ventilation

Relations

low tidal volume

Relations

prone ventilation

Relations

higher tidal volumes

Relations

optimizing ventilation

Relations

incremental PEEP

Relations

higher PEEP strategy

Relations

lower PEEP strategy

Relations

prone position

Description

Lying flat, especially face downward.

Alternatives

proning
prone

Relations

Sources

Oxfordhttps://www.lexico.com/en/definition/prone

Medications

Diagram