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Клинический случай успешного применения неинвазивной вентиляции легких у пациента с новой коронавирусной инфекцией
Литвин А.Ю., Елфимова Е.М., Михайлова О.О. и др. Клинический случай успешного применения неинвазивной вентиляции легких у пациента с новой коронавирусной инфекцией. Consilium Medicum. 2020; 22 (10): 23–28.
DOI: 10.26442/20751753.2020.10.200291
DOI: 10.26442/20751753.2020.10.200291
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Litvin A.Yu., Elfimova E.M., Mikhailova O.O. et al. Сlinical case of successful use of non-invasive ventilation in a patient with a new coronavirus infection. Consilium Medicum. 2020; 22 (10): 23–28. DOI: 10.26442/20751753.2020.10.200291
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Аннотация
Новая коронавирусная инфекция COVID-19 (SARS-CoV-2) – это вызов как с точки зрения оптимальной тактики ведения больных, так и защиты медицинского персонала. Мы приводим клинический случай пациента 49 лет с двусторонней полисегментарной пневмонией (COVID-19), осложнившейся острым респираторным дистресс-синдромом и «цитокиновым штормом», у которого выбранная тактика терапии с использованием неинвазивной вентиляции легких позволила избежать интубации и организовать адекватную защиту медицинского персонала.
Ключевые слова: неинвазивная вентиляция легких, COVID-19, новая коронавирусная инфекция, пневмония, респираторная поддержка.
Ключевые слова: неинвазивная вентиляция легких, COVID-19, новая коронавирусная инфекция, пневмония, респираторная поддержка.
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The new coronavirus disease COVID-19 (SARS-CoV-2) is a challenge both in terms of optimal patient management and the protection of the medical personnel. We present a clinical case of a 49-year-old patient with bilateral polysegmental pneumonia (COVID-19), complicated by acute respiratory distress syndrome and a cytokine storm, in whom the chosen treatment tactics using non-invasive ventilation allowed avoidance of intubation together with organization of sufficient protection for medical personnel.
Key words: non-invasive ventilation, COVID-19, new coronavirus infection, pneumonia, respiratory support.
Полный текст
Список литературы
1. Guan W, Ni Z, Hu Y et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; 382: 1708–20. DOI: 10.1056/NEJMoa2002032
2. Wang D, Hu B, Hu C et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020. DOI: 10.1001/jama.2020.1585
3. Hernandez AV, Roman YM, Pasupuleti V et al. Hydroxychloroquine or Chloroquine for Treatment or Prophylaxis of COVID-19: A Living Systematic Review. Ann Intern Med 2020; 10.7326/M20-2496. DOI: 10.7326/M20-2496
4. Cao B, Wang Y, Wen D et al. A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med 2020; 382 (19): 1787‐–99. DOI: 10.1056/NEJMoa2001282
5. Alattar R, Ibrahim TBH, Shaar SH et al. Tocilizumab for the treatment of severe COVID‐19. J Med Virol 2020; 1–8. DOI: 10.1002/jmv.25964
6. Michot JM, Albiges L, Chaput N et al. Tocilizumab, an anti-IL6 receptor antibody, to treat Covid-19-related respiratory failure: a case report. Ann Oncol 2020. DOI: 10.1016/j.annonc.2020.03.300.
7. Lillicrap D. Disseminated intravascular coagulation in patients with 2019-nCoV pneumonia. J Thromb Haemost 2020. DOI: 10.1111/jth.14781
8. Zhang Y, Xiao M, Zhang S et al. Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19. N Engl J Med 2020. DOI: 10.1056/NEJMc2007575
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11. Marini JJ, Gattinoni L. Management of COVID-19 Respiratory Distress. JAMA 2020. DOI: 10.1001/jama.2020.6825
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13. Yang X, Yu Y, Xu J et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020. DOI: 10.1016/S2213-2600(20)30079-5
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15. Hui DS, Chow BK, Lo T et al. Exhaled air dispersion during high-flow nasal cannula therapy versus CPAP via different masks. Eur Respir J 2019; 53 (4): 1802339. DOI: 10.1183/13993003.02339-2018
16. Simonds AK, Hanak A, Chatwin M et al. Evaluation of droplet dispersion during non-invasive ventilation, oxygen therapy, nebuliser treatment and chest physiotherapy in clinical practice: implications for management of pandemic influenza and other airborne infections. Health Technol Assess 2010; 14 (46): 131–72. DOI: 10.3310/hta14460-02
17. Nicas M, Nazaroff WW, Hubbard A. Toward understanding the risk of secondary airborne infection: emission of respirable pathogens. J Occup Environ Hyg 2005; 2 (3): 143–54. DOI: 10.1080/15459620590918466
18. Bourouiba L. Turbulent Gas Clouds and Respiratory Pathogen Emissions: Potential Implications for Reducing Transmission of COVID-19. JAMA 2020; 10.1001/jama.2020.4756. DOI: 10.1001/jama.2020.4756. PMID: 32215590
19. NHS (2020). Guidance for the role and use of non-invasive respiratory support in adult patients with coronavirus (confirmed or suspected). 2020 March 26.
20. Seto WH, Tsang D, Yung RW et al. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). Lancet 2003; 361: 1519–20. DOI: 10.1016/s0140-6736(03)13168-6
2. Wang D, Hu B, Hu C et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020. DOI: 10.1001/jama.2020.1585
3. Hernandez AV, Roman YM, Pasupuleti V et al. Hydroxychloroquine or Chloroquine for Treatment or Prophylaxis of COVID-19: A Living Systematic Review. Ann Intern Med 2020; 10.7326/M20-2496. DOI: 10.7326/M20-2496
4. Cao B, Wang Y, Wen D et al. A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med 2020; 382 (19): 1787‐–99. DOI: 10.1056/NEJMoa2001282
5. Alattar R, Ibrahim TBH, Shaar SH et al. Tocilizumab for the treatment of severe COVID‐19. J Med Virol 2020; 1–8. DOI: 10.1002/jmv.25964
6. Michot JM, Albiges L, Chaput N et al. Tocilizumab, an anti-IL6 receptor antibody, to treat Covid-19-related respiratory failure: a case report. Ann Oncol 2020. DOI: 10.1016/j.annonc.2020.03.300.
7. Lillicrap D. Disseminated intravascular coagulation in patients with 2019-nCoV pneumonia. J Thromb Haemost 2020. DOI: 10.1111/jth.14781
8. Zhang Y, Xiao M, Zhang S et al. Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19. N Engl J Med 2020. DOI: 10.1056/NEJMc2007575
9. Huang C, Wang Y, Li X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497–506. DOI: 10.1016/S0140-6736(20)30183-5
10. Brochard L, Slutsky A, Pesenti A. Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med 2017; 195 (4): 438–42. DOI: 10.1164/rccm.201605-1081CP
11. Marini JJ, Gattinoni L. Management of COVID-19 Respiratory Distress. JAMA 2020. DOI: 10.1001/jama.2020.6825
12. Nicolini A, Cilloniz C, Piroddi IG et al. Noninvasive ventilation for acute respiratory failure due to community-acquired pneumonia: A concise review and update. Community Acquired Infection 2015; 2 (2): 46. DOI: 10.4103/2225-6482.159224
13. Yang X, Yu Y, Xu J et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020. DOI: 10.1016/S2213-2600(20)30079-5
14. Tran K, Cimon K, Severn M et al. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One 2012; 7: e35797. DOI: 10.1371/journal.pone.0035797. PMID: 22563403.
15. Hui DS, Chow BK, Lo T et al. Exhaled air dispersion during high-flow nasal cannula therapy versus CPAP via different masks. Eur Respir J 2019; 53 (4): 1802339. DOI: 10.1183/13993003.02339-2018
16. Simonds AK, Hanak A, Chatwin M et al. Evaluation of droplet dispersion during non-invasive ventilation, oxygen therapy, nebuliser treatment and chest physiotherapy in clinical practice: implications for management of pandemic influenza and other airborne infections. Health Technol Assess 2010; 14 (46): 131–72. DOI: 10.3310/hta14460-02
17. Nicas M, Nazaroff WW, Hubbard A. Toward understanding the risk of secondary airborne infection: emission of respirable pathogens. J Occup Environ Hyg 2005; 2 (3): 143–54. DOI: 10.1080/15459620590918466
18. Bourouiba L. Turbulent Gas Clouds and Respiratory Pathogen Emissions: Potential Implications for Reducing Transmission of COVID-19. JAMA 2020; 10.1001/jama.2020.4756. DOI: 10.1001/jama.2020.4756. PMID: 32215590
19. NHS (2020). Guidance for the role and use of non-invasive respiratory support in adult patients with coronavirus (confirmed or suspected). 2020 March 26.
20. Seto WH, Tsang D, Yung RW et al. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). Lancet 2003; 361: 1519–20. DOI: 10.1016/s0140-6736(03)13168-6
________________________________________________
1. Guan W, Ni Z, Hu Y et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; 382: 1708–20. DOI: 10.1056/NEJMoa2002032
2. Wang D, Hu B, Hu C et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020. DOI: 10.1001/jama.2020.1585
3. Hernandez AV, Roman YM, Pasupuleti V et al. Hydroxychloroquine or Chloroquine for Treatment or Prophylaxis of COVID-19: A Living Systematic Review. Ann Intern Med 2020; 10.7326/M20-2496. DOI: 10.7326/M20-2496
4. Cao B, Wang Y, Wen D et al. A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med 2020; 382 (19): 1787‐–99. DOI: 10.1056/NEJMoa2001282
5. Alattar R, Ibrahim TBH, Shaar SH et al. Tocilizumab for the treatment of severe COVID‐19. J Med Virol 2020; 1–8. DOI: 10.1002/jmv.25964
6. Michot JM, Albiges L, Chaput N et al. Tocilizumab, an anti-IL6 receptor antibody, to treat Covid-19-related respiratory failure: a case report. Ann Oncol 2020. DOI: 10.1016/j.annonc.2020.03.300.
7. Lillicrap D. Disseminated intravascular coagulation in patients with 2019-nCoV pneumonia. J Thromb Haemost 2020. DOI: 10.1111/jth.14781
8. Zhang Y, Xiao M, Zhang S et al. Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19. N Engl J Med 2020. DOI: 10.1056/NEJMc2007575
9. Huang C, Wang Y, Li X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497–506. DOI: 10.1016/S0140-6736(20)30183-5
10. Brochard L, Slutsky A, Pesenti A. Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med 2017; 195 (4): 438–42. DOI: 10.1164/rccm.201605-1081CP
11. Marini JJ, Gattinoni L. Management of COVID-19 Respiratory Distress. JAMA 2020. DOI: 10.1001/jama.2020.6825
12. Nicolini A, Cilloniz C, Piroddi IG et al. Noninvasive ventilation for acute respiratory failure due to community-acquired pneumonia: A concise review and update. Community Acquired Infection 2015; 2 (2): 46. DOI: 10.4103/2225-6482.159224
13. Yang X, Yu Y, Xu J et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020. DOI: 10.1016/S2213-2600(20)30079-5
14. Tran K, Cimon K, Severn M et al. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One 2012; 7: e35797. DOI: 10.1371/journal.pone.0035797. PMID: 22563403.
15. Hui DS, Chow BK, Lo T et al. Exhaled air dispersion during high-flow nasal cannula therapy versus CPAP via different masks. Eur Respir J 2019; 53 (4): 1802339. DOI: 10.1183/13993003.02339-2018
16. Simonds AK, Hanak A, Chatwin M et al. Evaluation of droplet dispersion during non-invasive ventilation, oxygen therapy, nebuliser treatment and chest physiotherapy in clinical practice: implications for management of pandemic influenza and other airborne infections. Health Technol Assess 2010; 14 (46): 131–72. DOI: 10.3310/hta14460-02
17. Nicas M, Nazaroff WW, Hubbard A. Toward understanding the risk of secondary airborne infection: emission of respirable pathogens. J Occup Environ Hyg 2005; 2 (3): 143–54. DOI: 10.1080/15459620590918466
18. Bourouiba L. Turbulent Gas Clouds and Respiratory Pathogen Emissions: Potential Implications for Reducing Transmission of COVID-19. JAMA 2020; 10.1001/jama.2020.4756. DOI: 10.1001/jama.2020.4756. PMID: 32215590
19. NHS (2020). Guidance for the role and use of non-invasive respiratory support in adult patients with coronavirus (confirmed or suspected). 2020 March 26.
20. Seto WH, Tsang D, Yung RW et al. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). Lancet 2003; 361: 1519–20. DOI: 10.1016/s0140-6736(03)13168-6
Авторы
А.Ю. Литвин*1,2, Е.М. Елфимова1, О.О. Михайлова1, Т.А. Алексеева1, О.А. Сивакова1, Н.М. Данилов1, Д.В. Певзнер1, Л.О. Дулаев1, И.Т. Зюряев1, С.А. Гаман1
1 ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия;
2 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*alelitvin@yandex.ru
1 ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия;
2 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*alelitvin@yandex.ru
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Aleksandr Yu. Litvin*1,2, Evgeniia M. Elfimova1, Oksana O. Mikhailova1, Tatiana A. Alekseeva1, Olga A. Sivakova1, Nikolai M. Danilov1, Dmitrii V. Pevzner1, Lavrentii O. Dulaev1, Ilia T. Zyuryaev1, Svetlana A. Gaman1
1 National Medical Research Center for Cardiology, Moscow, Russia;
2 Pirogov Russian National Research Medical University, Moscow, Russia
*alelitvin@yandex.ru
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