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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Standardization of critical care management of non-critically ill patients with COVID-19
Chang-Song Wang, Yang Gao, Kai Kang, Dong-Sheng Fei, Xiang-Lin Meng, Hai-Tao Liu, Yun-Peng Luo, Wei Yang, Qing-Qing Dai, Yan Gao, Ming-Yan Zhao, Kai-Jiang Yu
Chang-Song Wang, Hai-Tao Liu, Department of Critical Care Medicine, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
Yang Gao, Kai Kang, Dong-Sheng Fei, Xiang-Lin Meng, Yun-Peng Luo, Wei Yang, Ming-Yan Zhao, Kai-Jiang Yu, Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Qing-Qing Dai, Department of Critical Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China
Yan Gao, Department of Critical Care Medicine, The Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Kai-Jiang Yu, Institute of Critical Care Medicine, The Sino Russian Medical Research Center of Harbin Medical University, Harbin 150081, Heilongjiang Province, China
Author contributions: Wang CS, Gao Y, Kang K, Fei DS, Meng XL, Liu HT, Luo YP, Yang W, Dai QQ, Gao Y, Zhao MY, and Yu KJ conceived and supervised the study, and designed and performed the experiments; Wang CS and Gao Y wrote the manuscript; Zhao MY and Yu KJ made manuscript revisions; all authors reviewed the results and approved the final version of the manuscript; Wang CS and Gao Y equally contributed to this work.
Supported by The National Natural Science Foundation of China, No. 81770276; Nn10 Program of Harbin Medical University Cancer Hospital; and Novel Coronavirus Pneumonia Emergency Treatment and Diagnosis Technology Research Project of Heilongjiang Provincial Science and Technology Department and Scientific Research Project of Heilongjiang Health and Family Planning Commission, No. 2018086.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Kai-Jiang Yu, MD, Doctor, Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 Youzheng Street, Harbin 150001, Heilongjiang Province, China.
yukaijiang002@sina.com
Received: October 23, 2020
Peer-review started: October 23, 2020
First decision: December 13, 2020
Revised: January 12, 2021
Accepted: February 25, 2021
Article in press: February 25, 2021
Published online: April 26, 2021
Processing time: 173 Days and 20 Hours
The large global outbreak of coronavirus disease 2019 (COVID-19) has seriously endangered the health care system in China and globally. The sudden surge of patients with severe acute respiratory syndrome coronavirus 2 infection has revealed the shortage of critical care medicine resources and intensivists. Currently, the management of non-critically ill patients with COVID-19 is performed mostly by non-intensive care unit (ICU) physicians, who lack the required professional knowledge, training, and practice in critical care medicine, especially in terms of continuous monitoring of the respiratory function, intervention, and feedback on treatment effects. This clinical problem needs an urgent solution. Therefore, here, we propose a series of clinical strategies for non-ICU physicians aimed at the standardization of the management of non-critically ill patients with COVID-19 from the perspective of critical care medicine. Isolation management is performed to facilitate the implementation of hierarchical monitoring and intervention to ensure the reasonable distribution of scarce critical care medical resources and intensivists, highlight the key patients, timely detection of disease progression, and early and appropriate intervention and organ function support, and thus improve the prognosis. Different management objectives are also set based on the high-risk factors and the severity of patients with COVID-19. The approaches suggested herein will facilitate the timely detection of disease progression, and thus ensure the provision of early and appropriate intervention and organ function support, which will eventually improve the prognosis.
Core Tip: The sudden surge of patients with severe acute respiratory syndrome coronavirus 2 infection has revealed the shortage of critical care medicine resources and intensivists. Therefore, the management of non-critically ill patients with coronavirus disease 2019 (COVID-19) is performed mostly by non-intensive care unit (ICU) physicians. We propose a series of clinical strategies for non-ICU physicians aimed at the standardization of the management of non-critically ill patients with COVID-19 from the perspective of critical care medicine, which are conductive to facilitating the timely detection of disease progression, ensure the provision of early and appropriate intervention and organ function support, and thus improve the prognosis.
