Managing the respiratory care of patients with COVID-19: Italian recommendations

Author(s): T. Troosters, ERS President

DocumentManaging the respiratory care of patients with COVID-19: Italian Thoracic Society, (AIPO), Italian Respiratory Society (SIP)

Authors: Harari SA, Vitacca M, Blasi F, Centanni S, Santus PA, Tarsia P with collaboration of Banfi PI, Bini, F, Casali W, Cassandro R, Ceriana P, Marruchella A, Massinesi G, Novelli L, Oggionni T, Riario SGG, Scarduelli C, Scartabellati A

Description: COVID-19 is a viral infection that is infecting European citizens rapidly. While most infections only result in relatively mild symptoms, still significant numbers of patients are hospitalized with severe pneumonia and need to be admitted to intensive care units across Europe, causing a sudden burden on the European health care system.

A severe clinical picture at disease onset can lead to death from massive diffuse alveolar damage resulting in end-stage respiratory failure. In this document experts from Italy discuss best practice as applied in Italy, based on available evidence. Topics include:

  • Patient management at first contact and after triage
  • What to do
  • Decontamination
  • Organisational aspects
  • Areas and paths
  • Staff protection

The document also contains a proposal for a treatment algorithms including O2, CPAP/NIV, endotracheal intubation.

Comments: As it is too early for formal practice guidelines according to classic ERS methodology, this statement summarised best practice answers from the Italian Respiratory Societies, faced first with the COVID-19 infection in Europe. The document is easy to read and is practical to apply. This is not an ERS statement, but it provides concrete handles for clinicians in Europe, particularly those working on critical care units.

Further recommendations:

Covid-19 blog
Respiratory critical care
Respiratory infections
Respiratory intensive care