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Managing critically ill adults with COVID-19: Surviving Sepsis Campaign guidelines

Alhazzani W et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med 2020;1 -34:Mar 28 [Online ahead of print]
7 April, 2020  

Infection with COVID-19 can lead to serious complication and even death. It is therefore important that guidance is available to help clinical staff when dealing with critically ill patients.

The Surviving Sepsis Campaign has therefore produced a guideline to support staff in managing critically ill patients with COVID-19. The guideline was produced by a panel of 36 experts from 12 countries and posed 53 questions relevant to the management of patients in the intensive care unit.

Because COVID-19 is a relatively new entity, the group were unable to find much relevant evidence but extrapolated data from other viral infections.

The panel produced a total of 54 statements including four best practice recommendations, nine strong recommendations and 35 weak recommendations but could not make any recommendations for six statements.

The statements covered infection control, laboratory diagnosis and specimens, haemodynamic support, ventilatory support and COVID-19 therapy. Interestingly, four of the statements for which there was no recommendation related to therapy, reflecting the lack of evidence around treatments such as chloroquine which has been suggested an effective therapy.

Another related to the uncertainty of whether to use a helmet or mask although as knowledge of the virus increases, these recommendations are likely to be quickly updated.