Tag: SARS-CoV-2

COVID-19 infographics

ECMO in COVID-19 related severe cardiopulmonary failure: visual summary of the recently published ELSO – Extracorporeal Life Support Organization Consensus guideline: unique considerations on when & how to provide ECLS in SARS-CoV-2 Coronavirus pandemic, with potential indications/contraindications. Download full document at https://bit.ly/ELSOCOVID19

Surviving Sepsis Campaign COVID-19 guidelines to support management of critically ill ICU patients with SARS-CoV-2 Coronavirus infection: here a graphic summary!
infection control, diagnosis & testing
hemodynamics support monitoring, fluids & vasoactives
non-invasive ventilatory support: SpO2 targets, conventional oxygen therapy, High Flow Nasal Cannula & Non-Invasive Positive Pressure Ventilation
invasive mechanical ventilation: MV settings, recruitment maneuver, prone posi
tioning, fluids, NMBAs & inhaled vasodilators
therapy: steroids antipyretics, antivirals, IVIg, convalescent plasma, rIFNs, chloroquine, tocilizumab & more!
full open access at https://bit.ly/SSCCOVID19

Basic advices & informal decisional algorithm by a study Group on management of critically ills COVID-19 patients based at Niguarda Ca’ Granda Hospital (Director Prof. R. Fumagalli) & Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico (Director Prof. A. Pesenti) in Milan,  Italy:
hot to set mechanical ventilation (initial acute phase, stabilization, weaning), hot to do recruitment maneuver & notes on porne positioning… to do or (maybe) not?
therapy: antivirals/adjuvants (be careful with lopinavir/ritonavir!) antibiotics, fluids/NE, analgesia & sedation, NMBA
temperature management
monitoring
Aim to stardardize treatments, optimizing outcome & resources consumption, and support physicians, nurses, HCPs dealing with severe respiratory failure related to COVID19, waiting for the response of the immune system, the most effective strategy!
By Thomas Langer & Nicola Bottino
Graphics by @foamecmo available both in English & Italian

Request full document with management advices to the authors
Thomas Langer thomas.langer@unimib.it
& Nicola Bottino bottino.nicola@gmail.com

PS Advices are based on preliminary informations collected during the first experience in China, and during the first week of the emergency in Lombardy, Northern of Italy; additional data ad evidence eventually arising will impose updating the recommendations.

COVID-19 network in Lombardy to early identify, triage & manage SARS-CoV-2 Coronavirus patients: JAMA livestream with Professor Maurizio Cecconi, Here a summary…
Do not underestimate! high percentage of patients will require hospitalization, high percentage will require intensive care: get ready, prepare now, work on protocols and have plans: outbreak could comes near to you! also check related paper by Prof Cecconi, Giacomo Grasselli and Antonio Pesenti just released on JAMA.

COVID19 dedicated GiViTI video conference with intensivists from North of Italy sharing their initial experience with Coronavirus SARSCoV19 epidemics: lung ultrasound LUS, prone positioning, MV, ECMO… it’s like a tsunami, you can’t understand if you are not in.
Recordings of the conference (for the ones speaking in Italian!) available link thanks to Istituto Mario Negri

How to manage critically ills with COVID19? be prepared! be familiar with case definition, ensure strict compliance with IPC, beware of diagnostic testing…
ESICM webinar with Prof Yaseen Arabi moderated by Lennie Derde. Here a graphics, slideset & summary available.

Missed the ESICM COVID-19 webinar with Professor Bin Du from China? here some dedicated notes: data about #Coronavirus pandemic, disease evolution, clinical features, organ failure & need for mechanical ventilation; check ESICM blog at for more data! full open access webinar here. A summary in the graphics.

ECMOCARD study

ExtraCorporeal Membrane Oxygenation for 2019 novel Coronavirus Acute Respiratory Disease ECMOCARD study is an multi-centre International study, conducted in all collaborating hospitals/ICU-based research networks in Asia, Australia & New Zealand (APELSO in collaboration with centres within the SPRINT-SARI and ISARIC Networks), and Europe, in COVID-19 patients requiringadmission to to ICU, Mechanical Ventilation &/or ECMO, to characterize:
incidence of ICU admission, need for non-invasive/invasive MV and ECMO 
risk factors, clinical features and severity of respiratory failure 
ECMO technical characteristics & duration of the run 
complications and ICU/Hospital survival 
requirements/time for approvals in participating network regions.

Aim is to recruit all eligible patients at each study location; patients will be studied specifically focusing on collecting data on MV, ECMO, main therapies (includinvasoactives, hypoxaemia rescue therapies, RRT), antibiotics/antivirals, adjunctive therapies, ie immunomodulators, corticosteroids, short-term outcomes.

Inclusion criteria

Laboratory-confirmed COVID-19 infection by real-time PCR and/or next-generation sequencing
Admission to an ICU

Exclusion criteria

MV for other concomitant causes 
ECMO for other concomitant causes 

Coronavirus

Family of RNA viruses which may infect mammals and birds, with 6 species known to cause human disease; 2 strains, the severe acute respiratory syndrome coronavirus SARS-CoV and Middle East respiratory syndrome coronavirus MERS-CoV have caused more serious, sometimes fatal, respiratory illnesses (reported mortality respectively 10% & 37%).

SARS-CoV-2 & COVID-19

In late December, 2019, in Wuhan, Hubei, China, new respiratory syndrome emerged with clinical signs resembling viral pneumonia and person-to-person transmission; analysis from lower respiratory tract samples corroborated emergence of novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 SARSCoV-2, causing  COrona VIrus Disease 2019 (COVID-19).