eISSN: 1731-2531
ISSN: 1642-5758
Anaesthesiology Intensive Therapy
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5/2020
vol. 52
 
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abstract:
Review article

COVID-19 and haemodynamic failure: a point of view on mechanisms and treatment

Tomasz Jasiński
1
,
Jan Stefaniak
1

1.
Department of Anaesthesiology and Intensive Therapy, Medical University of Gdansk, Poland
Anaesthesiol Intensive Ther 2020; 52, 5: 409–417
Online publish date: 2020/12/15
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The SARS-CoV-2-related disease has an undoubted impact on the healthcare system. In the treatment of severe COVID-19 cases, the main focus is on respiratory failure. However, available data suggest an important contribution of haemodynamic impairment in the course of this disease. SARS-CoV-2 may affect the circulatory system in various ways that are universal for septic conditions. Nonetheless, unique features of this pathogen, e.g. direct insult leading to myocarditis and renin-angiotensin-aldosterone axis dysregulation, must be taken into account. Although current recommendations on COVID-19 resemble previous septic shock guidelines, special attention to haemodynamic monitoring and treatment is necessary. Regarding treatment, one must take into account the potential profound hypovolaemia of severe COVID-19 patients. Pharmacological cardiovascular support should follow existing guidelines and practice. Interesting concepts of decatecholaminisation and the effect of vasopressors on pulmonary circulation are also presented in this review on COVID-19-related haemodynamic failure.
keywords:

hemodynamics, COVID-19, critical care, SARS-CoV-2, cardiovascular

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