Technologies to optimize the care of severe COVID-19 patients for healthcare providers challenged by limited resources.

ABSTRACT: Healthcare systems are belligerently responding to the new Coronavirus Disease 2019 (COVID-19). The severe acute respiratory syndrome (SARS co-V2) is a specific condition, whose distinctive features are severe hypoxemia associated with (>50% of cases) normal respiratory system compliance. When a patient requires intubation and invasive ventilation the outcome is poor and the length of stay in the intensive care unit (ICU) is usually two or three weeks. In this manuscript, authors will review several technological devices, which could support healthcare providers at the bedside to optimise the care for COVID-19 patients who are sedated, paralysed and ventilated. Particular attention is provided to the use of video-laryngoscopes (VL) because these can assist anaesthetists to perform a successful intubation outside the ICU while protecting healthcare providers from this viral infection. Authors will also review processed electroencephalographic (EEG) monitors which are used to better titrate sedation and the train of four monitors which are utilised to better titrate neuromuscular blocking agents in the view of sparing limited pharmacological resources. COVID-19 can rapidly exhaust human and technological resources too within the ICU. This review features a series of technological advancements that can significantly improve the care of patients requiring isolation. The working conditions in isolation could cause gaps or barriers in communication, fatigue and poor documentation of provided care. The available technology has several advantages including: a) facilitating appropriate paperless documentation and communication between all healthcare givers working in isolation rooms or large isolation areas; b) testing patients and staff at the bedside using smart point of care diagnostics (SPOCD) to confirm COVID-19 infection; c) allowing diagnostics and treatment at the bedside through point of care ultrasound (POCUS) and Thromboelastography (TEG); d) adapting the use of anaesthetic machines and the use of volatile anaesthetics. Implementing technologies for safeguarding healthcare providers as well as monitoring the limited pharmacological resources is paramount. Only by leveraging new technologies it will be possible to sustain and support healthcare systems during the expected long course of this pandemic.

SUBMITTER: Rubulotta F 

PROVIDER: S-EPMC7258840 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature