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Experts: Several clear early warning factors for new coronary pneumonia have been identified

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  • Experts: Several clear early warning factors for new coronary pneumonia have been identified

    Experts: Several clear early warning factors for new coronary pneumonia have been identified

    Low oxygenation index for over twelve hours, watch out!

    2020-02-14 07:00 Source: Southern Network Li Xiuting Zhu Xiaofeng
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      Since the outbreak, Li Yueping, director of the ICU of the Infectious Diseases Center of the Eighth People's Hospital of Guangzhou City, has been at the forefront of fighting the epidemic. She is responsible for the isolation of the first district, which is the place where the eighth hospital of Guangzhou city treats severe and critically ill patients. As of February 12, a total of 13 critically ill patients and more than 20 critically ill patients have been treated. At the same time, she is also carrying out non-stop scientific research on the treatment of new coronary pneumonia.

      Recently, she accepted an exclusive interview with Nanfang Daily to introduce the treatment of patients with severe and critically ill patients with new coronary pneumonia, and responded to the public's concerns about antiviral drugs for new coronary pneumonia.

      Keywords critical alert

      Cytokine storm is most likely induced by hypoxia

      Nanfang Daily: Why do some patients get worse and some patients get better?

      Li Yueping: We are conducting research on early and critical illness warning factors and found several very clear early warning factors, namely lymphocyte decline, lactate dehydrogenase increase, D2 polymer increase, continuous oxygenation index decrease, Viremia and so on.

      In addition, we found that exacerbated patients had had an oxygenation index of only 100-150 mmhg (normal value 400-500 mmhg) for more than 12 hours. Such patients may induce cytokine storms due to hypoxia.

      Many people have said that cytokine storms are sudden, but according to our daily observations from critical medical experts, cytokine storms are not sudden. It is likely to be induced by hypoxia. The same thing is that many people seem to have mild symptoms, shortness of breath, and respiratory distress are not obvious, but in fact, the oxygenation index has decreased significantly, and CT indicates multiple lung fields.

      Therefore, in the treatment of new coronary pneumonia, oxygen therapy is very important. Whether it is oxygen inhalation, high-flow oxygen therapy, non-invasive ventilation, or tracheal intubation, it is necessary to ensure that the patient's oxygen is sufficient. If a patient's oxygen supply can be guaranteed in the early stage, his chance of sudden development of severe illness will be a little smaller. At present, the Eighth People's Hospital of Guangzhou City has a pressurized central oxygen supply and the protection is adequate.

      Keywords intensive care

      Maintain organ function to help patients "pass"

      Nanfang Daily: Which antiviral drugs are currently effective?

      Li Yueping: Kelizhi, Abidol, Chloroquine, Redecide, these are the antiviral drugs that many people have high hopes for. We started this study on January 28. We set strict entry criteria, exclusion criteria, and observation indicators, as well as blank control groups to observe the efficacy of Abidol and Kelizhi. But so far, neither drug has had very encouraging results.

      We started the experimental research on chloroquine on February 8. In cooperation with the Zhongshan Fifth Hospital of Zhuhai, we launched a multi-center experimental study on chloroquine against viruses. Cao Bin of Beijing is also conducting a multi-center experiment on Radixivir to observe the antiviral effect. To date, these antivirals have not shown efficacy. From the cell level, to the tissue level, and then to the human level, the effect may be far worse.

      Nanfang Daily: Is it safe to find effective antiviral drugs?

      Li Yueping: Antiviral effects are one thing, but severe cases are another. Even with antiviral drugs, can it prevent the disease from progressing to severe cases? Not necessarily, this is related to everyone's immune status and subsequent cytokine storms. Virus testing has turned negative for several of our patients, but his condition has worsened. Even if there are antiviral drugs, they may not be able to completely treat all the critically ill patients.

      Therefore, in the treatment of new coronary pneumonia, intensive medicine is very important. It is to maintain the function of each organ of the patient to slowly survive the duration of the virus, including the support of the ventilator to the lung, and ECMO (external membrane pulmonary oxygenation). Support for cardiopulmonary function.

      This time with new coronary pneumonia, the virus lasts a long time, and lung failure takes a long time, and it takes a long time to support it. We now have 3 patients on ECMO. Of the 8 patients who were transferred to the Institute, there were also 3 of them. It has been 10 days. No patient has been successfully taken offline yet. Now we are in a quarantine area and we have gathered the three "ace soldiers" of infection, severe illness and breathing, hoping to work together to overcome this disease.

      Keywords outbreak control...