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

Anesthesiology. 2020 Jun;132(6):1317-1332. doi: 10.1097/ALN.0000000000003296.

Abstract

The COVID-19 outbreak has led to 80,409 diagnosed cases and 3,012 deaths in mainland China based on the data released on March 4, 2020. Approximately 3.2% of patients with COVID-19 required intubation and invasive ventilation at some point in the disease course. Providing best practices regarding intubation and ventilation for an overwhelming number of patients with COVID-19 amid an enhanced risk of cross-infection is a daunting undertaking. The authors presented the experience of caring for the critically ill patients with COVID-19 in Wuhan. It is extremely important to follow strict self-protection precautions. Timely, but not premature, intubation is crucial to counter a progressively enlarging oxygen debt despite high-flow oxygen therapy and bilevel positive airway pressure ventilation. Thorough preparation, satisfactory preoxygenation, modified rapid sequence induction, and rapid intubation using a video laryngoscope are widely used intubation strategies in Wuhan. Lung-protective ventilation, prone position ventilation, and adequate sedation and analgesia are essential components of ventilation management.

Publication types

  • Review

MeSH terms

  • China
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / prevention & control
  • Coronavirus Infections* / transmission
  • Disease Transmission, Infectious / prevention & control*
  • Hospitals / standards
  • Humans
  • Intubation, Intratracheal / standards*
  • Pandemics* / prevention & control
  • Patient Selection
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / prevention & control
  • Pneumonia, Viral* / transmission
  • Respiration, Artificial / standards*

Supplementary concepts

  • COVID-19