Progressive respiratory failure in COVID-19: a hypothesis
The coronavirus disease 2019 (COVID-19) pandemic is a challenge for intensive care units (ICUs) worldwide because of the large numbers of patients, a scarcity of resources, the poor prognosis of patients they treat, and uncertainty regarding the disease's pathogenesis. The presence of oedema is...
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| Veröffentlicht in: | The Lancet infectious diseases 2020-12, Vol.20 (12), p.1365-1365 |
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| creator | Endeman, Henrik van der Zee, Philip van Genderen, Michel E van den Akker, Johannes P C Gommers, Diederik |
| description | The coronavirus disease 2019 (COVID-19) pandemic is a challenge for intensive care units (ICUs) worldwide because of the large numbers of patients, a scarcity of resources, the poor prognosis of patients they treat, and uncertainty regarding the disease's pathogenesis. The presence of oedema is illustrated by ground-glass opacities of the lung parenchyma on lung CT.2 If patients require mechanical ventilation, oxygenation improves following prone positioning, higher PEEP, and restrictive fluid management. Based on our early findings in our first 90 patients with COVID-19, we now include D-dimer and IL-6 in our routine laboratory tests in patients with COVID-19, and increase the prophylactic dose of low-molecular-weight heparin(nadroparin 5700 IU subcutaneously, from once a day to twice a day).4 In addition, we do a lung CT even at a low level of suspicion of pulmonary embolism, and we encourage others to do the same. |
| doi_str_mv | 10.1016/S1473-3099(20)30366-2 |
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The presence of oedema is illustrated by ground-glass opacities of the lung parenchyma on lung CT.2 If patients require mechanical ventilation, oxygenation improves following prone positioning, higher PEEP, and restrictive fluid management. Based on our early findings in our first 90 patients with COVID-19, we now include D-dimer and IL-6 in our routine laboratory tests in patients with COVID-19, and increase the prophylactic dose of low-molecular-weight heparin(nadroparin 5700 IU subcutaneously, from once a day to twice a day).4 In addition, we do a lung CT even at a low level of suspicion of pulmonary embolism, and we encourage others to do the same.</description><identifier>ISSN: 1473-3099</identifier><identifier>EISSN: 1474-4457</identifier><identifier>DOI: 10.1016/S1473-3099(20)30366-2</identifier><identifier>PMID: 32530428</identifier><language>eng</language><publisher>United States: Elsevier Ltd</publisher><subject>Aged ; Cerebrospinal Fluid Pressure ; Coronaviruses ; Correspondence ; COVID-19 ; COVID-19 - complications ; Dimers ; Edema ; Embolism ; Female ; Fluid management ; Heparin ; Hospitals ; Humans ; Infectious diseases ; Intensive Care Units ; Interleukin 6 ; Laboratory tests ; Low level ; Lungs ; Male ; Mechanical ventilation ; Middle Aged ; Netherlands - epidemiology ; Obesity - complications ; Oxygenation ; Pandemics ; Parenchyma ; Pathogenesis ; Permeability ; Positive-Pressure Respiration, Intrinsic ; Prone Position ; Pulmonary Embolism - complications ; Pulmonary Embolism - etiology ; Pulmonary embolisms ; Respiratory Insufficiency - epidemiology ; Respiratory Insufficiency - etiology ; Sex Factors ; Thrombophilia - complications ; Thrombophilia - etiology ; Tidal Volume ; Ventilators ; Viral diseases</subject><ispartof>The Lancet infectious diseases, 2020-12, Vol.20 (12), p.1365-1365</ispartof><rights>2020 Elsevier Ltd</rights><rights>2020. Elsevier Ltd</rights><rights>2020 Elsevier Ltd. All rights reserved. 2020 Elsevier Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c523t-4bd582a4ab115dd0a4c824b64b6f2a6865f951c010b32bfa814a763fcff374f43</citedby><cites>FETCH-LOGICAL-c523t-4bd582a4ab115dd0a4c824b64b6f2a6865f951c010b32bfa814a763fcff374f43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1473309920303662$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32530428$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Endeman, Henrik</creatorcontrib><creatorcontrib>van der Zee, Philip</creatorcontrib><creatorcontrib>van Genderen, Michel E</creatorcontrib><creatorcontrib>van den Akker, Johannes P C</creatorcontrib><creatorcontrib>Gommers, Diederik</creatorcontrib><title>Progressive respiratory failure in COVID-19: a hypothesis</title><title>The Lancet infectious diseases</title><addtitle>Lancet Infect Dis</addtitle><description>The coronavirus disease 2019 (COVID-19) pandemic is a challenge for intensive care units (ICUs) worldwide because of the large numbers of patients, a scarcity of resources, the poor prognosis of patients they treat, and uncertainty regarding the disease's pathogenesis. The presence of oedema is illustrated by ground-glass opacities of the lung parenchyma on lung CT.2 If patients require mechanical ventilation, oxygenation improves following prone positioning, higher PEEP, and restrictive fluid management. Based on our early findings in our first 90 patients with COVID-19, we now include D-dimer and IL-6 in our routine laboratory tests in patients with COVID-19, and increase the prophylactic dose of low-molecular-weight heparin(nadroparin 5700 IU subcutaneously, from once a day to twice a day).4 In addition, we do a lung CT even at a low level of suspicion of pulmonary embolism, and we encourage others to do the same.</description><subject>Aged</subject><subject>Cerebrospinal Fluid Pressure</subject><subject>Coronaviruses</subject><subject>Correspondence</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>Dimers</subject><subject>Edema</subject><subject>Embolism</subject><subject>Female</subject><subject>Fluid management</subject><subject>Heparin</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Intensive Care Units</subject><subject>Interleukin 6</subject><subject>Laboratory tests</subject><subject>Low level</subject><subject>Lungs</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Middle Aged</subject><subject>Netherlands - epidemiology</subject><subject>Obesity - complications</subject><subject>Oxygenation</subject><subject>Pandemics</subject><subject>Parenchyma</subject><subject>Pathogenesis</subject><subject>Permeability</subject><subject>Positive-Pressure Respiration, Intrinsic</subject><subject>Prone Position</subject><subject>Pulmonary Embolism - complications</subject><subject>Pulmonary Embolism - etiology</subject><subject>Pulmonary embolisms</subject><subject>Respiratory Insufficiency - epidemiology</subject><subject>Respiratory Insufficiency - etiology</subject><subject>Sex Factors</subject><subject>Thrombophilia - complications</subject><subject>Thrombophilia - etiology</subject><subject>Tidal Volume</subject><subject>Ventilators</subject><subject>Viral diseases</subject><issn>1473-3099</issn><issn>1474-4457</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkdlKAzEUhoMoVquPoAx4Uy9Gs80SLxSpKxQquNyGTCZpU6aTmswU-vami0W9EQInJN_5z_IDcILgBYIovXxFNCMxgYz1MDwnkKRpjHfAQXimMaVJtru6r5EOOPR-AiHKEKT7oENwQiDF-QFgL86OnPLezFUU4sw40Vi3iLQwVetUZOqoP_x4vosRu4pENF7MbDNW3vgjsKdF5dXxJnbB-8P9W_8pHgwfn_u3g1gmmDQxLcokx4KKAqGkLKGgMse0SMPRWKR5mmiWIAkRLAgutMgRFVlKtNSaZFRT0gXXa91ZW0xVKVXdOFHxmTNT4RbcCsN__9RmzEd2zjPEIGYwCPQ2As5-tso3fGq8VFUlamVbzzFFmOWEMRbQsz_oxLauDuMFKqUk7Db01gXJmpLOeu-U3jaDIF-aw1fm8OXmOYZ8ZQ7HIe_05yTbrG83AnCzBlTY59wox700qpaqNE7JhpfW_FPiC-N2nas</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Endeman, Henrik</creator><creator>van der Zee, Philip</creator><creator>van Genderen, Michel E</creator><creator>van den Akker, Johannes P C</creator><creator>Gommers, Diederik</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8C2</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20201201</creationdate><title>Progressive respiratory failure in COVID-19: a hypothesis</title><author>Endeman, Henrik ; van der Zee, Philip ; van Genderen, Michel E ; van den Akker, Johannes P C ; Gommers, Diederik</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c523t-4bd582a4ab115dd0a4c824b64b6f2a6865f951c010b32bfa814a763fcff374f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Cerebrospinal Fluid Pressure</topic><topic>Coronaviruses</topic><topic>Correspondence</topic><topic>COVID-19</topic><topic>COVID-19 - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Lancet infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Endeman, Henrik</au><au>van der Zee, Philip</au><au>van Genderen, Michel E</au><au>van den Akker, Johannes P C</au><au>Gommers, Diederik</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Progressive respiratory failure in COVID-19: a hypothesis</atitle><jtitle>The Lancet infectious diseases</jtitle><addtitle>Lancet Infect Dis</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>20</volume><issue>12</issue><spage>1365</spage><epage>1365</epage><pages>1365-1365</pages><issn>1473-3099</issn><eissn>1474-4457</eissn><abstract>The coronavirus disease 2019 (COVID-19) pandemic is a challenge for intensive care units (ICUs) worldwide because of the large numbers of patients, a scarcity of resources, the poor prognosis of patients they treat, and uncertainty regarding the disease's pathogenesis. The presence of oedema is illustrated by ground-glass opacities of the lung parenchyma on lung CT.2 If patients require mechanical ventilation, oxygenation improves following prone positioning, higher PEEP, and restrictive fluid management. Based on our early findings in our first 90 patients with COVID-19, we now include D-dimer and IL-6 in our routine laboratory tests in patients with COVID-19, and increase the prophylactic dose of low-molecular-weight heparin(nadroparin 5700 IU subcutaneously, from once a day to twice a day).4 In addition, we do a lung CT even at a low level of suspicion of pulmonary embolism, and we encourage others to do the same.</abstract><cop>United States</cop><pub>Elsevier Ltd</pub><pmid>32530428</pmid><doi>10.1016/S1473-3099(20)30366-2</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Cerebrospinal Fluid Pressure Coronaviruses Correspondence COVID-19 COVID-19 - complications Dimers Edema Embolism Female Fluid management Heparin Hospitals Humans Infectious diseases Intensive Care Units Interleukin 6 Laboratory tests Low level Lungs Male Mechanical ventilation Middle Aged Netherlands - epidemiology Obesity - complications Oxygenation Pandemics Parenchyma Pathogenesis Permeability Positive-Pressure Respiration, Intrinsic Prone Position Pulmonary Embolism - complications Pulmonary Embolism - etiology Pulmonary embolisms Respiratory Insufficiency - epidemiology Respiratory Insufficiency - etiology Sex Factors Thrombophilia - complications Thrombophilia - etiology Tidal Volume Ventilators Viral diseases |
| title | Progressive respiratory failure in COVID-19: a hypothesis |
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