Expert Recommendations for Tracheal Intubation in Critically Ill Patients with Noval Coronavirus Disease 2019

Zuo Mingzhang; Huang Yuguang; Ma Wuhua; Xue Zhanggang; Zhang Jiaqiang; Gong Yahong; Che Lu; Chinese Society of Anesthesiology Task Force on Airway Management

doi:10.24920/003724

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Expert Recommendations for Tracheal Intubation in Critically Ill Patients with Noval Coronavirus Disease 2019

Chinese Medical Sciences Journal Vol. 35, Issue 2, Pages: 105-109(2020)

Guideline & Consensus | Updated：2024-04-10

- Expert Recommendations for Tracheal Intubation in Critically Ill Patients with Noval Coronavirus Disease 2019
- Affiliations：
  
  1. Department of Anesthesiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  2. Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  3. Department of Anesthesiology, First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
  4. Department of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai 200032, China
  5. Department of Anesthesiology, Henan Provincial People’s Hospital, Zhengzhou 450003, China
- Author bio：
  
  *, Mingzhang Zou, zuomz@163.com;
  Yuguang Huang, garybeijing@163.com. The non-author contributors are listed at the end of article.
- Funds：
- DOI：10.24920/003724
  CLC：
- Received：21 February 2020，
  
  Accepted：2020-2-26，
  
  Published Online：21 February 2020，
  
  Published：27 February 2020
- Accepted：
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Zuo Mingzhang, Huang Yuguang, Ma Wuhua, et al. Expert Recommendations for Tracheal Intubation in Critically Ill Patients with Noval Coronavirus Disease 2019[J]. Chinese medical sciences journal, 2020, 35(2): 105-109.
DOI：

Zuo Mingzhang, Huang Yuguang, Ma Wuhua, et al. Expert Recommendations for Tracheal Intubation in Critically Ill Patients with Noval Coronavirus Disease 2019[J]. Chinese medical sciences journal, 2020, 35(2): 105-109. DOI： 10.24920/003724.

摘要

Abstract

Coronavirus Disease 2019 (COVID-19)

caused by a novel coronavirus (SARS-CoV-2)

is a highly contagious disease. It firstly appeared in Wuhan

Hubei province of China in December 2019. During the next two months

it moved rapidly throughout China. Most of the infected patients have mild symptoms including fever

fatigue and cough

but in severe cases

patients can progress rapidly and develop into acute respiratory distress syndrome

septic shock

metabolic acidosis and coagulopathy. The new coronavirus was reported to spread via droplets

contact and natural aerosols from human to human. Therefore

aerosol-producing procedures such as endotracheal intubation may put the anesthesiologists at high risk of nosocomial infections. In fact

SARS-CoV-2 infection of anesthesiologists after endotracheal intubation for confirmed COVID-19 patients have been reported in hospitals in Wuhan. The expert panel of airway management in Chinese Society of Anaesthesiology has deliberated and drafted this recommendation

by which we hope to guide the performance of endotracheal intubation by frontline anesthesiologists and critical care physicians. During the airway management

enhanced droplet/airborne personal protective equitment (PPE) should be applied to the health care providers. A good airway assessment before airway intervention is of vital importance. For patients with normal airway

awake intubation should be avoided

and modified rapid sequence induction is strongly recommended. Sufficient muscle relaxant should be assured before intubation. For patients with difficult airway

good preparation of airway devices and detailed intubation plans should be made.

关键词

Keywords

references

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