A Contemporary Assessment of Acute Mechanical Ventilation in Beijing: Description, Costs, and Outcomes

Ye, Yanping; Zhu, Bo; Jiang, Li; Jiang, Qi; Wang, Meiping; Hua, Lin; Xi, Xiuming

doi:10.1097/ccm.0000000000002360

Cited by 24 publications

(31 citation statements)

References 38 publications

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“…patients. The treatment of mechanical ventilation in critical patients brings also huge medical burden [4] .So far, no specific anti-SARS-CoV-2 drug has been found successfully [8,9] .Therefore, it is extremely important to recognize the predictive risk factors of disease aggravation, identify severe disease early, give scientific and effective treatment programs, block the progression to severe disease, and avoid intubation and invasive mechanical ventilation in critical disease to reduce the case fatality rate. Based on successfully treatment of 97 COVID-19 patients (including 26 severe, 10 critical) in our hospital, we would like to share and discuss our experience in recognizing and intervention of severe early and timely.…”

Section: Discussionmentioning

confidence: 99%

“…Up to March 24, 2020, there are 812,18 confirmed patients and 3,281 deaths in 31 provinces in China [1] . In all world, there are 1051,635 confirmed cases and 56,985 confirmed deaths [2] , COVID-19 has a high case fatality rate in severe patients and a huge medical burden caused by invasive mechanical ventilation [3,4] , National Health Commission of the People's Republic of China has issued the relevant diagnosis and treatment guidelines for COVID - 19, which have been updated to the 7th edition [5] ,WHO also referred to the Chinese COVID -19 guidelines for diagnosis and treatment, and proposed internationally oriented advice on diagnosis and treatment [6] . However, with the continuous recognition of this new disease, we believe that the current diagnosis and treatment guidelines still need to be improved, such as the characteristic clinical symptoms of COVID-19, meaningful laboratory examination indicators, the diagnosis basis of covid-19 pneumonia, the limitation of glucocorticoid usage and dosage in treatment, and the choice of mechanical ventilation timing.…”

Section: Introductionmentioning

confidence: 99%

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Key to successful treatment of COVID-19: accurate identification of severe risks and early intervention of disease progression

chen

Tan

et al. 2020

Preprint

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Background：COVID-19 is a new and highly contagious respiratory disease that has caused global spread, high case fatality rate in severe patients, and a huge medical burden due to invasive mechanical ventilation. The current diagnosis and treatment guidelines are still need to be improved, and more excellent clinical experience is needed to provide reference. Methods：We analyzed and summarized clinical data of 97 confirmed COVID-19 adult patients (including 26 severe cases) ,included laboratory examination results, imaging findings, treatment effect, prognosis , etc, in order to put forward prediction index of severe COVID-19 patients, principles of early intervention and methylprednisolone usages in COVID-19 patients. Results： 1. Hypoxemia, hyperlactic acid, hypoproteinemia, and hypokalemia were prevalent in COVID-19 patients.The significant low lymphocyte count, hypoproteinemia, hypokalemia, the persistent or worsen high CRP, high D-dimer, and high BNP, and the occurrence of hemoptysis and novel coronavirus (SARS-CoV-2) viremia were important indicators for early diagnosis and prediction of severe disease progression. 2. Characteristic images of lung CT had a clear change in COVID -19, Ground-glass opacity (GGO) and high-density linear combinations may indicate different pathological changes. Rapid lobular progression of GGO suggests the possibility of severe disease. 3. Basic principles of early intervention treatment of COVID-19: on the premise of no effective antiviral drugs, treatment is based on supportive and symptomatic therapy (albumin supplementation, supplement of potassium, supplement blood plasma, etc.) in order to maintain the stability of the intracellular environment and adequately reactivate body immunity to clean up SARS-CoV-2 .4. According to severity, oxygenation index, body weight, age, underlying diseases, appropriate amount methylprednisolone application on severe/critical COVID-19 patients on demand, improved blood oxygen and reduced the utilization rate of invasive mechanical ventilation, case fatality rate and medical burden significantly.The most common indications for invasive mechanical ventilation should be strictly control in critical COVID-19 patients. Conclusions:1.Accurate and timely identification of clinical features in severe risks, and early and appropriate intervention can block disease progression. 2.Appropriate dose of methylprednisolone can effectively avoid invasive mechanical ventilation and reduce case fatality rate in critical COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Key to successful treatment of COVID-19: accurate identification of severe risks and early intervention of disease progression

chen

Tan

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…The majority of recent studies of health-related costs among Chinese patients with COPD have focused on specific interventions such as mechanical intervention [36], vaccination [37], or specific risk factor such as pollutants [38,39]. One study conducted in 2011 in four Chinese cities among 678 patients with COPD found that poorer quality of life as determined by the EuroQol-5 dimensions (EQ-5D) health questionnaire was significantly linked to increased medical costs [40].…”

Section: Discussionmentioning

confidence: 99%

REALizing and improving management of stable COPD in China: a multi-center, prospective, observational study to realize the current situation of COPD patients in China (REAL) – rationale, study design, and protocol

et al. 2020

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Background: Chronic obstructive pulmonary disease (COPD) is the fifth leading cause of death in China with a reported prevalence of 8.2% people aged ≥40 years. It is recommended that Chinese physicians follow Global Initiative for Chronic Obstructive Lung Disease (GOLD) and national guidelines, yet many patients with COPD in China remain undiagnosed. Furthermore, missed diagnoses and a lack of standardized diagnosis and treatment remain significant problems. The situation is further complicated by a lack of large-scale, long-term, prospective studies of real-world outcomes, including exacerbation rates, disease severity, efficacy of treatment, and compliance of COPD patients in China.

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“…Overall, NPPV has good cost‐effectiveness when used in general wards, which makes it an attractive option for respiratory support in underdeveloped countries . The use of ward‐based NPPV in selected patients can reduce intubation rates, demand for ICU beds, cost of treatment and nursing workload …”

Section: Strategies and Important Issues For Implementation Of Nppv Imentioning

confidence: 99%

“…37 The use of wardbased NPPV in selected patients can reduce intubation rates, demand for ICU beds, cost of treatment and nursing workload. 10,38 During NPPV, patients need to be monitored closely. Where intubation is inevitable, the switch from NPPV to intubation needs to be made early in order to avoid adverse outcomes caused by delayed intubation.…”

Section: Strategies and Important Issues For Implementation Of Nppv Imentioning

confidence: 99%

Challenges to and opportunities for the implementation of non‐invasive positive pressure ventilation in the Asia‐Pacific region

et al. 2019

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Non‐invasive positive pressure ventilation (NPPV) is undoubtedly one of the most significant advancements in mechanical ventilation technology in the past 30 years. With accumulating evidence from clinical studies and support from clinical guidelines, NPPV is now widely used in hospitals and increasingly prescribed for home therapy in the Asia‐Pacific region. However, in comparison with the developed Western countries, overall use of NPPV in the region is lagging behind. This study reviews this imbalance of NPPV use both in the acute and domiciliary settings in the Asia‐Pacific region. Important issues related to NPPV use are also discussed along with speculation around potential strategies that could promote wider implementation of NPPV in the region. We hope this review will stimulate interest in the clinical application and potential research avenues for NPPV in the Asia‐Pacific region, and promote education and staff training in the technique.

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A Contemporary Assessment of Acute Mechanical Ventilation in Beijing: Description, Costs, and Outcomes

Abstract: Supplemental Digital Content is available in the text.

Cited by 24 publications

References 38 publications

Key to successful treatment of COVID-19: accurate identification of severe risks and early intervention of disease progression

Key to successful treatment of COVID-19: accurate identification of severe risks and early intervention of disease progression

REALizing and improving management of stable COPD in China: a multi-center, prospective, observational study to realize the current situation of COPD patients in China (REAL) – rationale, study design, and protocol

Challenges to and opportunities for the implementation of non‐invasive positive pressure ventilation in the Asia‐Pacific region

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