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Crit Care Med. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)

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  • Crit Care Med. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)


    Crit Care Med. 2020 Mar 27. doi: 10.1097/CCM.0000000000004363. [Epub ahead of print]
    Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19).


    Alhazzani W1,2, M?ller MH3,4, Arabi YM5, Loeb M1,2, Gong MN6, Fan E7, Oczkowski S1,2, Levy MM8,9, Derde L10,11, Dzierba A12, Du B13, Aboodi M6, Wunsch H14,15, Cecconi M16,17, Koh Y18, Chertow DS19, Maitland K20, Alshamsi F21, Belley-Cote E1,22, Greco M16,17, Laundy M23, Morgan JS24, Kesecioglu J10, McGeer A25, Mermel L8, Mammen MJ26, Alexander PE2,27, Arrington A28, Centofanti JE29, Citerio G30,31, Baw B1,32, Memish ZA33, Hammond N34,35, Hayden FG36, Evans L37, Rhodes A38.

    Author information




    Abstract

    BACKGROUND:

    The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed.
    METHODS:

    We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations.
    RESULTS:

    The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which four are best practice statements, nine are strong recommendations, and 35 are weak recommendations. No recommendation was provided for six questions. The topics were: 1) infection control, 2) laboratory diagnosis and specimens, 3) hemodynamic support, 4) ventilatory support, and 5) COVID-19 therapy.
    CONCLUSION:

    The Surviving Sepsis Campaign COVID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19. When available, we will provide new evidence in further releases of these guidelines.



    PMID:32224769DOI:10.1097/CCM.0000000000004363

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