Review
Version 1
Preserved in Portico This version is not peer-reviewed
COVID-19 Related Organ Dysfunction and Management Strategies on the Intensive Care Unit
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Version 1
: Received: 22 July 2020 / Approved: 24 July 2020 / Online: 24 July 2020 (04:00:50 CEST)
A peer-reviewed article of this Preprint also exists.
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in a significant surge of critically ill patients and an unprecedented demand on intensive care services. The rapidly evolving understanding of pathogenesis, limited disease specific evidence and demand-resource imbalances have posed significant challenges for intensive care clinicians. COVID-19 is a complex multisystem inflammatory vasculopathy with a significant mortality implication for those admitted to intensive care. Institutional strategic preparation and meticulous intensive care support are essential to maximising outcomes during the pandemic. The significant mortality variation observed between institutions and internationally, despite a single aetiology and uniform presentation, highlights the potential influence of management strategies on outcome. Given that optimal organ support and adjunctive therapies for COVID-19 have not yet been well defined by trial-based outcomes, strategies are predicated on existing literature and experiential learning. This review outlines the relevant pathophysiology and management strategies for critically ill patients with COVID-19, and shares some of the collective learning accumulated in a high volume Severe Respiratory Failure centre in London.
Keywords
SARS-CoV-2; COVID-19; respiratory failure; ARDS; ventilation; MODS; ECMO
Subject
Medicine and Pharmacology, Anesthesiology and Pain Medicine
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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