COVID-19 Resources

Summary of recommendations on the management of patients with COVID-19 and ARDS

COVID-19 with mild ARDS COVID-19 with mod to severe ARDS Rescue/adjunctive therapy

DO: ! CONSIDER: UNCERTAIN:

Vt 4-8 ml/kg and Pplat <30 cm H2O Higher PEEP Antivirals, chloroquine, anti-IL6

DO:
! CONSIDER:
! CONSIDER: if proning, high Pplt,asynchrony
NMBA boluses to facilitate ventilation targets
Investigate for bacterial infection NMBA infusion for 24 h
! CONSIDER: if PEEP responsive
DO: Traditional recruitment maneuvers ! CONSIDER:
Target SpO2 92% - 96% Prone ventilation 12 -16 h
! CONSIDER:
! CONSIDER: Prone ventilation 12 -16 h
! CONSIDER: STOP if no quick response
Conservative fluid strategy
! CONSIDER: if proning, high Pplt, asynchrony
A trial of inhaled nitric oxide
NMBA infusion for 24 h
! CONSIDER:
! CONSIDER: follow local criteria for ECMO
Empiric antibiotics DON’T DO: V-V ECMO or referral to ECMO
Staircase recruitment maneuvers center
UNCERTAIN:
Systemic corticosteroids ! CONSIDER:
Mod = moderate
ARDS = adult respiratory distress syndrome
Short course of systemic corticosteroids Pplat = plateau pressure
SpO2 = peripheral capillary oxygen saturation
PEEP = positive end-expiratory pressure
UNCERTAIN:
NMBA = neuromuscular blocking agents
Antivirals, chloroquine, anti-IL6 ECMO = extracorporeal membrane oxygenation

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