Methods for a Seamless Transition From Tracheostomy to Spontaneous Breathing in Patients With COVID-19
Methods for a Seamless Transition From Tracheostomy to Spontaneous Breathing in Patients With COVID-19
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DOI：
10.4187/respcare.08157
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发表时间：
2020-11-01
期刊：
影响因子：
2.5
通讯作者：
Folch, Erik E.
中科院分区：
文献类型：
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作者：
Divo, Miguel J.;Oberg, Catherine L.;Folch, Erik E.
COVID-19大流行已深刻影响全球的医疗服务。一小部分呼吸衰竭患者在从病毒引起的损伤中恢复时需要长时间的机械通气。到目前为止，大多数报告都集中在这些患者的流行病学，临床因素和急性护理，较少关注需要延长机械通气时间的患者的恢复阶段和护理。在本文中，我们回顾了需要气管造口术、胃造口术、脱离机械通气和最终拔管的COVID-19患者的安全护理程序和方法。指导原则包括修改气道护理方法，以安全地预防医源性，并促进受COVID-19严重影响的患者的安全，包括减少气溶胶的产生，以最大限度地降低医护人员的风险。
The COVID-19 pandemic has profoundly affected health care delivery worldwide. A small yet significant number of patients with respiratory failure will require prolonged mechanical ventilation while recovering from the viral-induced injury. The majority of reports thus far have focused on the epidemiology, clinical factors, and acute care of these patients, with less attention given to the recovery phase and care of those patients requiring extended time on mechanical ventilation. In this paper, we review the procedures and methods to safely care for patients with COVID-19 who require tracheostomy, gastrostomy, weaning from mechanical ventilation, and final decannulation. The guiding principles consist of modifications in the methods of airway care to safely prevent iatrogenesis and to promote safety in patients severely affected by COVID-19, including mitigation of aerosol generation to minimize risk for health care workers.