四川大学华西医院普通重症监护病房新型冠状病毒肺炎防控紧急推荐与实践

Urgent recommendation and practice of prevention and control of novel coronavirus disease 2019(COVID-19)in intensive care units in West China Hospital of Sichuan University during the epidemics

目的为新型冠状病毒肺炎(COVID-19)疫情期间普通重症监护病房管理提供建议。方法紧急成立专题小组,通过讨论提出5个关键临床问题。检索PubMed、美国国立指南库、中国疾病预防控制中心等23个数据库和网站,检索时间为建库至2020年2月28日。收集文献、提取信息,通过小组讨论,对证据分级,采用GRADE系统进行推荐。将推荐应用于我院重症医学科小儿重症监护病房管理。结果共检索到文献13321篇,最终纳入21篇,经过2次讨论,提出5个推荐:(1)患者佩戴医用外科口罩;(2)禁止家属进入病区探视,采用视频探视;(3)不增加环境消毒频率;(4)合理开展非医务人员(工人、保洁员)防疫知识培训;(5)医务人员不需穿防护服。此推荐已应用于病房管理35 d,患者、医务人员及非医务人员均无新型冠状病毒感染。结论采用循证医学方法进行紧急推荐,有助于病房科学、高效管理,也适用于类似紧急公共卫生事件中普通重症监护病房的管理。

Objective To provide recommendations for the management of intensive care unit patients without novel coronavirus disease 2019(COVID-19).Methods We set up a focus group urgently and identified five key clinical issues through discussion.Total 23 databases or websites including PubMed,National Guideline Clearing-House,Chinese Center for Disease Control and Prevention and so on were searched from construction of the library until February 28,2020.After group discussion and collecting information,we used GRADE system to classify the evidence and give recommendations.Then we apply the recommendations to manage pediatric intensive care unit in the department of critical care medicine in our hospital.Results We searched 13321 articles and finally identified 21 liteteratures.We discussed twice,and five recommendations were proposed:(1)Patients should wear medical surgical masks;(2)Family members are not allowed to visit the ward and video visitation are used;(3)It doesn’t need to increase the frequency of environmental disinfection;(4)We should provide proper health education about the disease to non-medical staff(workers,cleaners);(5)Medical staff do not need wear protective clothing.We used these recommendations in intensive care unit management for 35 days and there was no novel coronavirus infection in patients,medical staff or non-medical staff.Conclusion The use of evidence-based medicine for emergency recommendation is helpful for the scientific and efficient management of wards,and is also suitable for the management of general intensive care units in emergent public health events.