In December 2019, a novel acute respiratory virus called COVID-19 (SARS-CoV-2) created an epidemic in Wuhan, China and in a few short months grew to an unprecedented incidence of infection and mortality across the globe leading to a pandemic. Eighty percent of COVID-19 patients only experience mild symptoms and will recover within 2 weeks. The other 20% of those effected are not as lucky; they become critically ill with acute respiratory failure, acute respiratory distress syndrome and shock.
The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) and other health organizations around the world have developed recommendations for screening, infection control and diagnosis in the noncritically ill population; recommendations for critically ill patients has been missing.
In response to this need, the Surviving Sepsis Campaign partnered with leading experts from 12 countries across the globe (many who have had direct experience caring for these patients), to develop a practice guideline on managing critically ill patients with COVID-19. The culmination of their work is called: “Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019.”
Their work addresses five areas including: infection control, laboratory diagnosis, hemodynamic support, ventilatory support and COVID-19 therapy. The guidelines have been accepted and will be published in Critical Care Medicine,
the journal of the Society of Critical Care Medicine and Intensive Care Medicine
, the journal of the European Society of Intensive Care Medicine.
For those of us who practice in critical care, these guidelines are instrumental as we face an unprecedented onslaught of patients requiring our services and expertise. The guidelines offer recommendations on wearing the correct type of mask, acute resuscitation using balanced/buffered crystalloids, oxygenation and ventilation, and optimizing hemodynamics.
While there is no cure for COVID-19 at this time, these guidelines offer us a start at having evidence-based, best practice recommendations to inform our clinical decision making. Throughout history, healthcare professionals have been faced with situations where they need to combine their expertise with a spirit of inquiry to determine which interventions have the best efficacy and outcomes. We will learn together as a united, global healthcare team, how best to care for these patients.
Full guideline: Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)