Palabras clave
Unidades de Cuidados Intensivos
Síndrome Respiratorio Agudo Grave
Cómo citar
Resumen
Esta es una revisión temática sobre aspectos relacionados con enfermedad por SARS COV2 (COVID-19) y la Unidad de Cuidados Intensivos. Se establecen algunos lineamientos para tener en cuenta ante la eventual necesidad de hospitalizar en la Unidad de Cuidados Intensivos a pacientes con COVID-19 críticamente enfermos, con intervención de la vía aérea, el uso de la ventilación mecánica y todas las condiciones tanto de seguridad, como clínicas y epidemiológicas que se generan en estas circunstancias.
En Colombia aparece el primer caso de COVID-19 el 6 de marzo de 2020, como caso importado de una joven proveniente de Milán (Italia); a partir de ahí, cada día ha habido reporte de casos, todos con índice epidemiológico y noción de contagio de un paciente o persona infectada fuera del país, siendo para el 15 de marzo en horas de la mañana 34 casos, y crecimiento muy rápido. Para el 17 de marzo, dos días después, son 64 casos según boletín del Ministerio de Salud y Protección Social del país. Se considera que estamos en la fase de contención para pronto pasar a la mitigación con circulación interna del virus.
Citas
Lai C-C, Shih T-P, Ko W-C, Tang H-J, Hsueh P-R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;2:105924. https://doi.org/10.1016/j.ijantimicag.2020.105924
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;1-9.
Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;1-13. https://doi.org/10.1101/2020.02.06.20020974
Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;6736(20):1-10. https://doi.org/10.1016/S0140-6736(20)30251-8
Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;(PG-102433):102433. https://doi.org/10.1016/j.jaut.2020.102433
Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares Global Emergency: A review of the 2019 Novel Coronavirus (COVID-19). Int J Surg. 2020;(PG-). https://doi.org/10.1016/j.ijsu.2020.02.034
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. https://doi.org/10.1016/S0140-6736(20)30183-5
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA - J Am Med Assoc. 2020;1-9. https://doi.org/10.1001/jama.2020.1585
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. https://doi.org/10.1016/S0140-6736(20)30211-7
Yoon SH, Lee KH, Kim JY, Lee YK, Ko H, Kim KH, et al. Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine Patients Treated in Korea. Korean J Radiol. 2020;(PG-10.3348/kjr.2020.0132):10.3348/kjr.2020.0132. https://doi.org/10.3348/kjr.2020.0132
Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;3099(20):1-10. https://doi.org/10.1016/S1473-3099(20)30086-4
Bogotá M de S y PS. Lineamientos para la detección y manejo de casos de covid-19 por los prestadores de servicios de salud en colombia. 2020;1-16.
World Health Organization. Clinical management of when novel coronavirus is suspected: severe acute respiratory infections What to do and what not to do. 2020;12.
Bouadma L, Lescure F-X, Yazdanpanah Y, Timsit J-F. Severe SARS-CoV-2 infections: practical considerations and management strategy for intensivists. Intensive Care Med. 2020;(PG-).
https://doi.org/10.1007/s00134-020-05967-x
Li Z, Yi Y, Luo X, Xiong N, Liu Y, Li S, et al. Development and Clinical Application of A Rapid IgM-IgG Combined Antibody Test for SARS-CoV-2 Infection Diagnosis. J Med Virol. 2020;0-1.
https://doi.org/10.1002/jmv.25727
Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, DeBoisblanc B, et al. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med. 2006;354(24):2564-75. https://doi.org/10.1056/NEJMoa062200
Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Vol. 45, Critical Care Medicine. 2017. 486-552 p.
Montufar FE, Varón FA, Sáenz OA. Infectio Asociación Colombiana de Infectología Recomendaciones para el diagnóstico , tratamiento y prevención de la neumonía adquirida en la comunidad en adultos Recommendations for diagnosis , treatment and prevention of community-acquired pneumonia in i. Infectio. 2013;17(Supl 1):1-38. https://doi.org/10.1016/S0123-9392(13)70019-5
Zuo M-Z, Huang Y-G, Ma W-H, Xue Z-G, Zhang J-Q, Gong Y-H, et al. Expert Recommendations for Tracheal Intubation in Critically ill Patients with Noval Coronavirus Disease 2019. Chinese Med Sci J = Chung-kuo i hsueh k'o hsueh tsa chih. 2020;0(0):0. https://doi.org/10.24920/003724
Ministerio de Sanidad. Documento técnico Manejo clínico de pacientes con enfermedad por el nuevo coronavirus. 2020;1-36.
Usman OA, Usman AA, Ward MA. Comparison of SIRS, qSOFA, and NEWS for the early identification of sepsis in the Emergency Department. Am J Emerg Med. 2019;37(8):1490-7.
https://doi.org/10.1016/j.ajem.2018.10.058
Liao X, Wang B, Kang Y. Novel coronavirus infection during the 2019-2020 epidemic: preparing intensive care units-the experience in Sichuan Province, China. Intensive Care Med. 2020;
https://doi.org/10.1007/s00134-020-05954-2
Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of clinical criteria for sepsis for the third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA - J Am Med Assoc. 2016;315(8):762-74. https://doi.org/10.1001/jama.2016.0288
James FR, Power N, Laha S. Decision-making in intensive care medicine - A review. J Intensive Care Soc. 2018;19(3):247-58. https://doi.org/10.1177/1751143717746566
Carrillo-Esper R, Sánchez-Zúñiga M de J, Medveczky-Ordóñez N, Carrillo-Córdova DM. Evolución de la definición del síndrome de insuficiencia respiratoria aguda. Med Interna México. 2018;34(4):594-600.
Vincent JL, De Backer D. Circulatory shock. N Engl J Med. 2013;369(18):1726-34.
https://doi.org/10.1056/NEJMra1208943
Juan-Torres A, Harbarth S. Prevention of primary bacteraemia. Int J Antimicrob Agents. 2007;30(SUPPL. 1):80-7. https://doi.org/10.1016/j.ijantimicag.2007.06.021
Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016;63(5):e61-111. https://doi.org/10.1093/cid/ciw353
Waugh JB, Epps CA, Khodneva YA. Capnography enhances surveillance of respiratory events during procedural sedation: A meta-analysis. J Clin Anesth. 2011;23(3):189-96.
https://doi.org/10.1016/j.jclinane.2010.08.012
Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anesth. 2020;
https://doi.org/10.1007/s12630-020-01591-x
Hui DS, Chow BK, Lo T, Tsang OTY, Ko FW, Ng SS, et al. Exhaled air dispersion during high-flow nasal cannula therapy versus CPAP via different masks. Eur Respir J. 2019;53(4).
https://doi.org/10.1183/13993003.02339-2018
Cheung TMT, Yam LYC, So LKY, Lau ACW, Poon E, Kong BMH, et al. Effectiveness of noninvasive positive pressure ventilation in the treatment of acute respiratory failure in severe acute respiratory syndrome. Chest. 2004;126(3):845-50. https://doi.org/10.1378/chest.126.3.845
Organization. WH. Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected: interim guidance. 2020;1-11.
Canadian Anesthesiologists' Society. COVID-19 RECOMMENDATIONS DURING AIRWAY MANIPULATION. 2020. p. https://www.cas.ca/en/practice-resources/the-healt.
Pierrakos. Acute Respiratory Distress Syndrome: Pathophysiology and Therapeutic Options. J Clin Med Res. 2012;4(1):7-16. https://doi.org/10.4021/jocmr761w
Carrillo-Esper R, De La Torre-León T, Carrillo-Córdova CA, Carrillo-Córdova DM. Actualidades en la definición, fisiopatología y tratamiento de la lesión pulmonar aguda. Med Interna Mex. 2015;31(5):578-89.
Katzenstein ALA, Bloor CM, Leibow AA. Diffuse alveolar damage: the role of oxygen, shock, and related factors. A review. Am J Pathol. 1976;85(1):210-28.
Thille AW, Esteban A, Fernández-Segoviano P, Rodriguez JM, Aramburu JA, Vargas-Errázuriz P, et al. Chronology of histological lesions in acute respiratory distress syndrome with diff use alveolar damage: A prospective cohort study of clinical autopsies. Lancet Respir Med. 2013;1(5):395-401. https://doi.org/10.1016/S2213-2600(13)70053-5
Krul IM, Sc M, Lugtenburg PJ, Ph D, Leeuwen FE Van, Ph D. Lung Recruitment in Patients with the Acute Respiratory Distress Syndrome Luciano. 2015;1609-19.
Estenssoro E, Reina R, Canales HS, Saenz MG, Gonzalez FE, Aprea MM, et al. The distinct clinical profile of chronically critically ill patients: A cohort study. Crit Care. 2006;10(3):1-9.
https://doi.org/10.1186/cc4941
Sacks FM, Harris A, Sc M, Johnson DW, Ph D, Kesselhut J, et al. One-Year Outcomes in Survivors of the Acute Respiratory Distress Syndrome Margaret. Science (80- ). 2009;360:609-19.
Estenssoro E, Dubin A. ARTÍCULO ESPECIAL SÍNDROME DE DISTRÉS RESPIRATORIO AGUDO Epidemiología y factores de riesgo El SDRA constituye una causa de admisión frecuente a la. Medicina (B Aires). 2016;76(4):235-41.
Wang K. The experience of high flow nasal cannula in hospitalized patients with 2019 novel coronavirus - infected pneumonia in Chongqing , China CURRENT STATUS : POSTED. 2019;1-17.
https://doi.org/10.21203/rs.2.24633/v1
Hui DS, Chow BK, Lo T, Ng SS, Ko FW, Gin T, et al. Exhaled air dispersion during noninvasive ventilation via helmets and a total facemask. Chest. 2015;147(5):1336-43. https://doi.org/10.1378/chest.14-1934
Cabrini L, Landoni G, Zangrillo A. Minimise nosocomial spread of 2019-nCoV when treating acute respiratory failure. Lancet. 2020;6736(20):30359. https://doi.org/10.1016/S0140-6736(20)30359-7
Kovacs RJ. HFSA / ACC / AHA Statement Addresses Concerns Re : Using RAAS Antagonists in COVID 19. ACC. 2020;2:18-21.
Organization WH. Infection prevention and control during health care for probable or confirmed cases of novel coronavirus ( nCoV ) infection. 2013;(May):1-9.
Cheung JC-H, Ho LT, Cheng JV, Cham EYK, Lam KN. Staff safety during emergency airway management for COVID-19 in Hong Kong. Lancet Respir Med. 2020;2600(20):30084.
https://doi.org/10.1016/S2213-2600(20)30084-9
Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Vol. 43, Intensive Care Medicine. Springer Berlin Heidelberg; 2017. 304-377 p.
Tian S, Hu W, Niu L, Liu H, Xu H, Xiao S-Y. Pulmonary pathology of early phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J Thorac Oncol. 2020;
https://doi.org/10.20944/preprints202002.0220.v2
Thompson BT, Bernard GR. ARDS Network (NHLBI) Studies: Successes and Challenges in ARDS Clinical Research. Crit Care Clin. 2011;27(3):459-68. https://doi.org/10.1016/j.ccc.2011.05.011
Guérin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T, et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med. 2013;368(23):2159-68.
https://doi.org/10.1056/NEJMoa1214103
Fan E, Del Sorbo L, Goligher EC, Hodgson CL, Munshi L, Walkey AJ, et al. An official American Thoracic Society/European Society of intensive care medicine/society of critical care medicine clinical practice guideline: Mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 2017;195(9):1253-63. https://doi.org/10.1164/rccm.201703-0548ST
Amato MBP, Meade MO, Slutsky AS, Brochard L, Costa ELV, Schoenfeld DA, et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med. 2014;372(8):747-55. https://doi.org/10.1056/NEJMsa1410639
Cavalcanti AB, Suzumura ÉA, Laranjeira LN, De Moraes Paisani D, Damiani LP, Guimarães HP, et al. Effect of lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome - A randomized clinical trial. JAMA - J Am Med Assoc. 2017;318(14):1335-45. https://doi.org/10.1001/jama.2017.14171
Chamorro C, Romera MA, Pardo C, Silva JA. Nuevos bloqueadores neuromusculares. Med Intensiva. 2001;25(9):340-3. https://doi.org/10.1016/S0210-5691(01)79719-7
Fong P, Boss D, Yap T, Tutt A, Wu P, Mergui-Roelvink M. Neuromuscular Blockers in Early Acute Respiratory Distress Syndrome. Science (80- ). 2010;609-19.
Del Sorbo L, Tonetti T, Ranieri VM. Alveolar recruitment in acute respiratory distress syndrome: should we open the lung (no matter what) or may accept (part of) the lung closed? Intensive Care Med. 2019;45(10):1436-9. https://doi.org/10.1007/s00134-019-05734-7
Meduri GU, Bridges L, Shih MC, Marik PE, Siemieniuk RAC, Kocak M. Prolonged glucocorticoid treatment is associated with improved ARDS outcomes: analysis of individual patients' data from four randomized trials and trial-level meta-analysis of the updated literature. Intensive Care Med. 2016;42(5):829-40. https://doi.org/10.1007/s00134-015-4095-4
Alshahrani MS, Sindi A, Alshamsi F, Al-Omari A, El Tahan M, Alahmadi B, et al. Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus. Ann Intensive Care. 2018;8(1). https://doi.org/10.1186/s13613-017-0350-x
Kain T, Fowler R. Preparing intensive care for the next pandemic influenza. Crit Care. 2019;23(1):1-9. https://doi.org/10.1186/s13054-019-2616-1
Álvarez CA, , Jorge Alberto Cortés, Carlos Hernando Gómez3 JAF, Sossa MP, , Fabián Beltrán6, Giovane Mendieta Izquierdo FMA, Ortiz G, Padilla10 A, et al. Guías de práctica clínica para la prevención de infecciones intrahospitalarias asociadas al uso de dispositivos médicos associated with the use of medical devices. (571):292-308. https://doi.org/10.1016/S0123-9392(10)70123-5
Group BMJ Publishing. Possible efficacy of Anti-viral cocktails in novel coronavirus. bmj. 2020;368:m406.