Edwards Lifesciences: COVID-19 support
As understanding of the novel SARS-CoV-2 virus and resulting COVID-19 disease evolves almost daily, clinicians around the world are in constant discussions on how best to care for, treat, and manage patients with COVID-19 and resulting sepsis, septic shock, and/or acute respiratory distress syndrome (ARDS). Their focus is on supporting ideal oxygenation and maintaining appropriate fluid balance to minimize severe life-threatening complications. Included within this newsletter are resources that can help clinicians minimize the complexity of managing fluids in patients hospitalized with COVID-19.
Dr. Manuel Ignacio Monge Garcia, Staff Intensivist, discusses his perspective on management of the COVID patient in an interview with Professor Monty Mythen and Desiree Chappell, CRNA.
"I think that probably one of the main reasons for the impairment of the renal function could be related to our hemodynamic management of those patients. We try to do the same thing with the ARDS patient as with patients that are not ARDS patients. I mean, we saw patients with normal chest x-rays or almost normal, but we tried to keep those lungs dry. You see a lot of diuretics or trying to reduce the intake of fluids and probably that kind of management could impair the renal function."
Read more from his interview here
The following is an example of how some hospitals are initially treating preload/volume with emphasis on the stroke volume response approach.
Stroke volume optimization % change in stroke volume (ΔSV) is a sensitive method for assessing preload responsiveness in all patients.
“No monitoring device, no matter how simple or complex, invasive or noninvasive, inaccurate or precise will improve outcomes unless coupled to a treatment, which itself improves outcome.”1
Pinsky and Payen
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