Importance of respiratory airway management as well as psychological and rehabilitative treatments to COVID-19 patients

Am J Emerg Med. 2020 Aug;38(8):1698.e1-1698.e4. doi: 10.1016/j.ajem.2020.04.055. Epub 2020 Apr 30.

Abstract

The clinical therapy for severe 2019 coronavirus disease (i.e., COVID-19) sufferers is relatively challenging. Herein, the processes involving salvage of a critical COVID-19 patient were retrospectively analyzed. The condition of an obese female critical COVID-19 sufferer progressively worsened in the initial period after admission. According to her symptoms and examination reports, endotracheal intubation and mechanical ventilation were timely conducted and meanwhile high-dose sedatives and analgesics were administrated. In the later therapeutic phase, however, sedative and analgesic dosages were gradually reduced, and psychological and rehabilitative therapies were conducted, concomitantly with enhancement of airway care to facilitate sputum expectoration. Eventually, the endotracheal tube was feasibly removed after intubation for 18 days and subsequently replaced with noninvasive ventilation and a high-flow nasal cannula oxygen therapy. Intensive airway care alongside psychological and rehabilitative therapies can shorten the mechanical ventilation time and improve the prognosis of COVID-19 sufferers.

Keywords: 2019 coronavirus disease (COVID-19); Mechanical ventilation; Psychological therapy; Rehabilitative therapy; Respiratory airway care.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Airway Management / methods*
  • Analgesics / therapeutic use
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / diagnostic imaging
  • Coronavirus Infections / psychology*
  • Coronavirus Infections / therapy*
  • Critical Care
  • Female
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Intubation, Intratracheal
  • Noninvasive Ventilation
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / diagnostic imaging
  • Pneumonia, Viral / psychology*
  • Pneumonia, Viral / therapy*
  • Respiration, Artificial
  • SARS-CoV-2
  • Tomography, X-Ray Computed

Substances

  • Analgesics
  • Hypnotics and Sedatives