Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)
Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)
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DOI：
10.1007/s00134-020-06022-5
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发表时间：
2020-06-01
影响因子：
8.8
通讯作者：
Rhodes, Andrew
中科院分区：
文献类型：
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作者：
Alhazzani, Waleed;Moller, Morten Hylander;Rhodes, Andrew
新型严重急性呼吸综合征冠状病毒2（SARS-CoV-2）是一种快速传播的疾病，即2019冠状病毒病（COVID-19）的原因，影响了世界各地成千上万的人。需要为照顾这些患者中病情最严重的临床医生提供紧急指导。方法我们组成了一个由来自12个国家的36名专家组成的小组。所有小组成员都填写了世界卫生组织利益冲突披露表。该小组提出了53个与ICU中COVID-19管理相关的问题。我们检索了有关ICU重症患者COVID-19管理的直接和间接证据的文献。我们确定了与支持性治疗有关的大多数问题的相关和最近的系统综述。我们使用建议分级、评估、开发和评价（GRADE）方法评估了证据的确定性，然后根据利益和危害、资源和成本影响、公平性和可行性之间的平衡生成建议。这些建议或强或弱，或以最佳做法建议的形式提出。2019冠状病毒病幸存者运动小组发布了54份声明，其中4份是最佳实践声明，9份是强烈建议，35份是弱建议。6个问题未提出建议。这些专题是：（1）感染控制，（2）实验室诊断和标本，（3）血流动力学支持，（4）净化支持，（5）COVID-19治疗。结论败血症生存运动COVID-19专家组发布了几项建议，以帮助支持医护人员照顾重症监护室的COVID-19患者。当可用时，我们将在这些指南的进一步发布中提供新的建议。背景：新型严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）是一种快速传播的疾病，即2019冠状病毒病（COVID-19）的原因，影响了世界各地成千上万的人。我们组成了一个由来自12个国家的36名专家组成的专家小组。所有小组成员都填写了世界卫生组织利益冲突披露表。该小组提出了53个与ICU中COVID-19管理相关的问题。我们检索了有关ICU重症患者COVID-19管理的直接和间接证据的文献。我们确定了与支持性治疗有关的大多数问题的相关和最近的系统综述。我们使用建议分级、评估、开发和评价（GRADE）方法评估了证据的确定性，然后根据利益和危害、资源和成本影响、公平性和可行性之间的平衡生成建议。结果：幸存脓毒症运动COVID-19专家组发布了54份声明，其中4份是最佳实践声明，9份是强建议，35份是弱建议。没有就6个问题提出建议。这些专题是：1）感染控制，2）实验室诊断和标本，3）血流动力学支持，4）净化支持，5）COVID-19治疗。结论：幸存脓毒症运动COVID-19小组发布了几项建议，以帮助支持医护人员照顾重症监护室的COVID-19患者。当可用时，我们将在这些指南的进一步发布中提供新的证据。
Background The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed. Methods We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations. Results The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which 4 are best practice statements, 9 are strong recommendations, and 35 are weak recommendations. No recommendation was provided for 6 questions. The topics were: (1) infection control, (2) laboratory diagnosis and specimens, (3) hemodynamic support, (4) ventilatory support, and (5) COVID-19 therapy. Conclusion The Surviving Sepsis Campaign COVID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19. When available, we will provide new recommendations in further releases of these guidelines.Background:The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed.Methods:We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations.Results:The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which four are best practice statements, nine are strong recommendations, and 35 are weak recommendations. No recommendation was provided for six questions. The topics were: 1) infection control, 2) laboratory diagnosis and specimens, 3) hemodynamic support, 4) ventilatory support, and 5) COVID-19 therapy.Conclusion:The Surviving Sepsis Campaign COVID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19. When available, we will provide new evidence in further releases of these guidelines.