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International Journal of Medical Sciences

.: Home > International Journal of Medical Sciences > 2004 > Volume 1 Number 1 > Arthur Chun-Wing LAU, Loretta Yin-Chun YAM, Loletta Kit-Ying SO

Management of Critically Ill Patients with Severe Acute Respiratory Syndrome (SARS)

Arthur Chun-Wing LAU, Loretta Yin-Chun YAM, Loletta Kit-Ying SO
Division of Respiratory and Critical Care Medicine, Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, PR China
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  randomizedcontrolled trials are required for confirmation. Physicians and scientists
all over the world should collaborate to study this condition which may potentially threaten human existence.

Keywords :
SARS, severe acute respiratory syndrome, critically ill patients, management, treatment and control.

Date Deposited : 03 Aug 2011 11:10

Last Modified : 04 Aug 2011 10:07

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Volume 1, Number 1, - 2004 , ISSN 1449-1907

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