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Intubation and Ventilation amid the COVID-19 Outbreak: Wuhan's Experience

Lingzhong Meng1, Haibo Qiu, Li Wan

  • 1From the Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (L.M., R.D.) the Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China (H.Q.) the Department of Anesthesiology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China (L.W.) the Departments of Critical Care Medicine (Y.A., L.Z.) Anesthesiology (Q.G.) Respiratory Medicine (J.M.), Xiangya Hospital, Central South University, Changsha, Hunan Province, China the Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China (Z.X.) the Department of Anesthesiology, Wake Forest University, Winston-Salem, North Carolina (C.T.) the Department of Anesthesiology and Pain Medicine, University of California Davis, Sacramento, California (H.L.) the Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, Tongji University School of Medicine, Shanghai, China (L.X.).

Anesthesiology
|March 21, 2020
PubMed

Insights

Critical care for COVID-19 patients requires careful intubation and ventilation strategies. This study outlines best practices for managing severe cases, emphasizing self-protection and timely interventions to improve outcomes.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Respiratory Medicine

Background:

  • The COVID-19 pandemic presented significant challenges in managing critically ill patients.
  • A substantial percentage of patients required invasive ventilation, increasing risks for healthcare workers.

Purpose of the Study:

  • To share experiences and best practices for intubation and ventilation of critically ill COVID-19 patients.
  • To guide healthcare providers in managing mechanical ventilation for COVID-19.

Main Methods:

  • Review of clinical experience in Wuhan, China, during the COVID-19 outbreak.
  • Emphasis on strict personal protective equipment (PPE) and infection control.
  • Description of intubation strategies including modified rapid sequence induction and video laryngoscopy.
  • Outline of ventilation management including lung-protective ventilation and prone positioning.

Main Results:

  • Timely intubation is crucial to prevent worsening oxygen debt.
  • Modified rapid sequence induction with video laryngoscopy facilitates safe and efficient intubation.
  • Lung-protective ventilation, prone positioning, and adequate sedation are key for managing ventilation.

Conclusions:

  • Strict adherence to self-protection is paramount for healthcare providers.
  • A systematic approach to intubation and ventilation is essential for critically ill COVID-19 patients.
  • These practices aim to optimize patient care and minimize cross-infection risks.

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