Síntesis de evidencia y recomendaciones: Guía para el cuidado de pacientes adultos críticos con COVID-19 en las Américas

Abstract

INTRODUCTION: In 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has spread around the world. Approximately 5% of infected patients are critical cases that require admission to the intensive care unit (ICU). In these patients, COVID-19 can be complicated by acute respiratory distress syndrome, septic shock, and multi-organ failure, including kidney and heart failure. OBJECTIVE: Summarize the recommendations included in the Guidelines for Care of Critically Ill Adult Patients with COVID-19 in the Americas, version 3, published by the Pan American Health Organization in 2021 to guide the management of critically ill adult patients with COVID-19 treated in the ICU, and address key aspects of implementation of the recommendations. METHODOLOGY: The guidelines and their recommendations were summarized. In addition, a systematic search was carried out in Pubmed, Lilacs, Health Systems Evidence, Epistemonikos, and gray literature on studies carried out in the Region of the Americas, in order to identify barriers, facilitators, and implementation strategies. RESULTS: Forty-three recommendations are presented that address the identification of markers and risk factors for mortality, infection prevention and control, specimen collection, supportive care (ventilatory and hemodynamic), pharmacological treatment, early rehabilitation, use of imaging studies, prevention of complications, and discharge criteria for critical patients with COVID-19. CONCLUSIONS: The recommendations seek to provide knowledge on the management of critical patients with COVID-19 and offer considerations for implementation of the recommendations in the Region.

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