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Colegio de Medicina Interna de México.

2020, Number 4

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Med Int Mex 2020; 36 (4)

Integral management of COVID-19 patients at the intensive care unit of a second-level hospital

Ordoñez-Espinosa G, Gallardo-Hernández AG, Hernández-Pérez AL, Revilla-Monsalve C, Bermúdez-Ochoa MG, Mejía-Velázquez NE, López-Islas I, Hernández-Hernández NA, Guevara-García AN, Reveles-Zavala L, De la Cerda-Ángeles JC, Maxil-Sánchez AJ

Language: Spanish
References: 29
Page: 596-606
PDF size: 387.41 Kb.


ABSTRACT

Background: The COVID-19 pandemic developed rapidly, on 27 May there were 78,023 positive cases and 8597 deaths in Mexico, many of the seriously ill patients have been attended in secondary health care facilities. In this study, we developed a comprehensive management strategy for the critically ill patient with COVID-19 specific for second-level hospitals. COVID-19 patients present a systemic inflammatory response, mainly at the pulmonary level, thus reducing tissue perfusion. Therefore, the main objective of managing the seriously ill patient COVID-19 was to guarantee adequate tissue perfusion and maintain hemodynamic stability to avoid complications in organs and systems such as cardiac arrhythmias or QT segment prolongation, which are presented as a side effect of some of the treatments for COVID-19, as well as an adequate hydroelectrolytic and hemodynamic balance to minimize the risk of incidence of kidney injury.
Clinical cases: This paper report the case of three patients care at the intensive care unit of General Hospital Enrique Cabrera of Mexico City.
Conclusions: This study presents strategies for the treatment of these patients only with non-invasive monitoring and offers measures of mechanical ventilation without alveolar recruitment.


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