Dear friends, as Chinese doctor, I have some suggestions to your anti-epidemic situation on the Covid-19.
1. Pulmonary lavage may be the most effective treatment for the patients. As you know, the pathologicalchangesinthepatient’slungswerethatalargeamountofeffusionwasgatheredinperipheral bronchioleandformedintothicksputumwhichcouldnotbesuckedouteasily.Wecanseethewhite lungsinthesepatients’thoracicCTforthereasonoftheeffusion.Notonlythethicksputumcanlead to respiratory failure but also it can develop bacteria infection which cause the sudden worsen of the diseaseandevendeath.Onlypulmonarylavagecanremovethethicksputumandcurethesepatients.
2. Patients can benefit from these special measures, such as clapping their back, prone ventilation, criticaliymornitoringthehumilityofinhalingfixedgasontherespiratorlestformingthephlegmem- bolism.
3. Massaging the lungs Once the plegm embolism have formed and could be drained out easily, the lungscouldbeshrinkedandswelledeasilysothatthephlegmcouldbeeliminatedoutfreely.Against this, we can open the patient’s chest a small incision, insert a balloon into it and inflate the balloon. Then the lungs may be shrinked and the phlegm may be moved.
4. ECMO Should be used prudently. In China, the ECMO was took high hopes at the starting of the plague.Butwehavefoundthatitssideeffectscouldnotbeaccepted.Actually,itcanprovideoxygen only,cannottreatthevirusesandchangethepathologicaldamagesinthelungs,forexample,thethick sputum.
5.InfusionofwholebloodofnormalpeopleorplasmaofarecoveredCovid-19patientWehavefound that the total lymph cells in these pneumonia patients’ blood have reduced markedly on the report of the Blood Routine. So, it may be useful for them to infusing whole blood of normal blood donor. As youhaveknown, arecoveredCovid-19patient’s plasmacankill the virusesvery effectively.
6. PointstonoteofthepatientsdevelopedrespiratoryfailureThesepatientsmaybetrachealintubated toventilate.Firstofall,inordertoavoidthegermsinfectioninthelungsbecauseoftrachealintubation, performing suction regularly is very important. And that, the tracheal catheter should be exchanged regularly in 24hrs. To perform this measure, there are two methods, one is that we can extubate the originalcatheterandintubateanewtrachealcatheteronceagain,theotheristoexchangethecatheter employingtheLANSHANtrachealcatheterandguidebougie.Asyoucanseethetwofigures,wecan intubate the guide bougie into the original catheter up to the patient’s tracheal, and extubate the originalcatheter,retaintheguidebougie,thenintubatetheLANSHANtrachealcatheterintothepatient’s trachealalongtheguidebougie.BymeansoftheLANSHANsuit,thedoctorwillworkveryeasilyand can not be infected easily by the Covid-19 pneumonia patients.
7. Above the preventions of disseminating Similar to many other viruses, air humidity is very important, viruses cannot be alive in dryairforalongtime.So,Isuggestthatthedehumidificationfunc- tion key on the air conditioner must be switched on.
Citation:Zhiyang Chen. Some Suggestions on the Treatment of Covid-19 Pneumonia. Annals of Clinical and Medical Case Reports 2020