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Management of Critically Ill Patients with Severe Acute Respiratory Syndrome (SARS)
Article Number: SIS478163AI191222
19th December, 2022
Author(s):
Arthur Chun-Wing LAU, Loretta Yin-Chun YAM, Loletta Kit-Ying SO
Abstract:
Severe acute respiratory syndrome (SARS) is frequently complicated with
acute respiratory failure. In this article, we aim to focus on the
management of the subgroup of SARS patients who are critically ill. Most
SARS patients would require high flow oxygen supplementation, 20–30%
required intensive care unit (ICU) or high dependency care, and 13–26%
developed acute respiratory distress syndrome (ARDS). In some of these
patients, the clinical course can progress relentlessly to septic shock
and/or multiple organ dysfunction syndrome (MODS). The management
of critically ill SARS patients requires timely institution of
pharmacotherapy where applicable and supportive treatment (oxygen
therapy, noninvasive and invasive ventilation). Superimposed bacterial
and other opportunistic infections are common, especially in those
treated with mechanical ventilation. Subcutaneous emphysema,
pneumothoraces and pneumomediastinum may arise spontaneously or as
a result of positive ventilatory assistance. Older age is a consistently a
poor prognostic factor. Appropriate use of personal protection equipment
and adherence to infection control measures is mandatory for effective
infection control. Much of the knowledge about the clinical aspects of
SARS is based on retrospective observational data and randomized controlled trials are required for confirmation. Physicians and scientists
all over the world should collaborate to study this condition which may
potentially threaten human existence.