Evidence-Based Recommendations to Help Care for COVID-19 Patients in the ICU

The journals of Critical Care Medicine and Intensive Care Medicine have co-published new clinical practice guidelines for physicians treating intensive care unit (ICU) patients with COVID-19. According to Science Daily, the guidance covers topics including “infection control, laboratory diagnosis and specimens, the dynamics of blood flow support, ventilation support and COVID-19 therapy.”

Science Daily reports that the research, compiled by the Surviving Sepsis Campaign COVID-19 panel, addresses questions considered to be most “relevant to the management of COVID-19 in the ICU.” Based on scientific evidence, the panel summarizes four best practices that should be adopted as the standard of care. As quoted directly from Science Daily,

• “Health-care workers performing aerosol-generating procedures, such as intubation, bronchoscopy, open suctioning, on patients with COVID-19 should wear fitted respirator masks, such as N95, FFP2 or equivalent — instead of surgical masks — in addition to other personal protective equipment, such as gloves, gown and eye protection.”

• “Aerosol-generating procedures should be performed on ICU patients with COVID-19 in a negative pressure room, if available. Negative pressure rooms are engineered to prevent the spread of contagious pathogens from room to room.”

• “Endotracheal intubation of patients with COVID-19 should be performed by health-care workers with experience in airway management to minimize the number of attempts and risk of transmission.”

• “Adults with COVID-19 who are being treated with non-invasive positive pressure ventilation or a high flow nasal cannula should be closely monitored for worsening respiratory status and intubated early if needed.”

While the World Health Organization and the Centers for Disease Control and Prevention have issued preliminary guidance on infection control, screening and diagnosis in the general population, study author Waleed Alhazzani says that, up until this point, there’s been very limited information on acute management of critically ill patients with COVID-19.

The panel of researchers say they will update and modify the guidelines as needed based on the discovery of any new evidence. Click here for more information on The Surviving Sepsis Campaign COVID-19.

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