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COVID-19

Our solution to help manage, monitor, and treat COVID-19, acute respiratory distress (ARDS), and sepsis patients

The novel coronavirus, SARS-CoV-2, which has resulted in COVID-19 disease is a highly contagious severe respiratory infection that has resulted in a global pandemic. Health care providers worldwide are trying to determine the best way to monitor, manage, and treat COVID-19 patients. Once fluid builds up in the alveoli in the lungs it prevents the lungs from filling with enough air, which in turn means less oxygen reaches the bloodstream. By not having enough oxygen the organs become deprived and begin to lose function which results in secondary complications.

 

The most common secondary complications are pneumonia, severe pneumonia, acute respiratory distress syndrome (ARDS), sepsis, and septic shock. The main treatment focus is obtaining ideal oxygenation (delivery and consumption), fluid balance, and cardiac function in order to reduce further complications and to ensure that the patient is maintaining appropriate levels for recovery . 

Supportive care such as hemodynamic monitoring has proven to be an integral part in the treatment of COVID-19 patients. The current gold standard for hemodynamic management is by using a pulmonary artery catheter (PAC) or central venous catheter (CVC). Due to the complexity and highly invasive nature of these catheters, the chance of infection and catheter-related complications is high and it has been suggested that PAC should not be used routinely in ARDS or hemodynamically unstable patients . Transthoracic Echocardiography (TTE) is an accurate and precise method for estimating cardiac hemodyanmics however it does not provide continuous measurements without a health care worker in contact with the patient and in order to achieve accurate results intensivists need to be highly trained in critical care echocardiography . Easy to use, noninvasive, and continuous hemodynamic monitoring coupled with treatment protocols is a crticial tool needed for health care workers to support and treat COVID-19 patients. 

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Our solution to help monitor, manage, and support COVID-19 

 

Based upon the number of patient's being intubated on a daily basis due to COVID-19, health care workers are experiencing the need for non-invasive measures that don't rely on the calibration or imports from the traditional catheter measurements. Our VenArt Cardiac Output is a completely noninvasive hemodynamic monitoring system which is being implemented to help monitor, manage, and support patients with COVID-19 and secondary complications.

Parameters monitored using the VenArt Cardiac Output 

SpO2 - Arterial oxygen saturation as an indication of oxygen delivery
 

SjvO2 - Venous oxygen saturation as an indication of oxygen consumption

CO and CI - Cardiac output  and Cardiac Index as indication of  cardiac function

SV and SVV - Stroke volume  and Stroke Volume Variation as an indication of cardiac function

Clinical applications that the VenArt Cardiac Output is being used for COVID-19

ARDS Patients - need for prone positioning with the intention to improve oxygenation but also correct the heart failure (especially right). SjvO2, CO, and SV are indicators of this improvement especially when acute heart failure exists 
 

Sepsis and Septic Shock - SjvO2, CO, and SV to monitor and guide resuscitation of septic shock

Ventilation Guidance - SjvO2 as a guidance for management of noninvasive ventilation before intubation, during transtubation, and during ventilation weaning. 

 

Acute Renal Failure - among the various causes of acute kidney injury (AKI), venous congestion whether it be due to cardiac failure or fluid overload is one of them. SjvO2 is a way to differentiate the different type of AKI (prerenal, renal, or postrenal) to allow more targeted treatment. 

Spontaneous Breathing Trial - SjvO2 is a useful parameter to further facilitate the accurate categorization among patients who pass or fail the spontaneous breathing trial. 

 

Additional Resources

 

World Health Organization

Latest Updates and Guidelines provided by the World Health Organization (WHO)
 

CDC
 

Information for Healthcare Professional about COVID-19 by the Centers for Disease Control and Prevention (CDC)

Canadian Government

Links to COVID-19 information for Canadians including current situation
 

Surviving Sepsis Campaign

Guidelines and management of critically ill adults with COVID-19 by the Surviving Sepsis Campaign (SSC)

Clinical syndromes associated with COVID-19 infection 1-4

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References​

  1. World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected. WHO/nCoV/Clinical/2020.2

  2. Siegel MD, Siemieniuk R. Acute respiratorydistress syndrome: Supportive care and oxygenation in adults:2020. [https://www.uptodate.com/contents/acute-respiratory-distress-syndrome-supportive-care-andoxygenation-in-adults] UpToDate; 2020

  3. Mayo P, Beaulieu Y, Doelken P, Feller-Kopman D,Harrod C, Kaplan A, et al. American College of Chest Physicians/La Société deRéanimation de Langue Française statement on competence in critical care ultrasonography. Chest. 2009;135:1050–60.

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