新型冠状病毒肺炎危重型患者气管插管术的专家建议(1.0版)

Expert recommendations for tracheal intubation in critically ill patients with coronavirus disease 2019(Version 1.0)

新型冠状病毒肺炎是一种传染性极强的呼吸道传染性疾病。多数患者症状较轻,主要表现为发热、乏力和咳嗽等症状。但部分重症患者可快速进展为急性呼吸窘迫综合征、感染性休克、严重的酸中毒和凝血功能紊乱,甚至发展为多器官功能衰竭。传播途径与其他呼吸道病毒类似,主要包括密切接触、飞沫和气溶胶传播。因此,医务人员在实施气管插管术等容易产生高病毒载量气溶胶的医疗操作时,面临着很高的职业暴露和传染的风险。针对新型冠状病毒肺炎危重型患者需要行气管插管术的现状,中华医学会麻醉学分会气道管理学组制订了"新型冠状病毒肺炎危重型患者气管插管术的专家建议(1.0版)"。该建议从气管插管术指征、安全防护措施、器具准备、气道评估、气管插管具体措施等方面进行阐述,旨在引导奋战在一线的麻醉科医师和危重症医学科医师安全有效地实施气管插管术。

Coronavirus disease 2019(COVID-19)is a kind of highly contagious disease.Most of the infected patients have mild symptoms including fever,fatigue and cough.But in severe cases,patients can progress rapidly and develop the acute respiratory distress syndrome,septic shock,metabolic acidosis and coagulopathy or even multiple organ failure.Like other respiratory viruses,severe acute respiratory syndrome coronavirus 2 is transmitted maily via contact,droplets and aerosols.Therefore,high-risk aerosol-producing procedures such as endotracheal intubation may put the anesthesiologists at high risk of nosocomial infections.Based on the current status in critically ill patients with coronavirus disease 2019 requiring tracheal intubation,the expert panel of Airway Management Group of Chinese Society of Anesthesiology deliberated and drafted this recommendation on several aspects,including indications for tracheal intubation,safety precautions,device preparation,airway evaluation and specific measures for tracheal intubation.This recommendation aimed to guide frontline anesthesiologists and critical care physicians to perform endotracheal intubation safely and effectively.