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*For medical professionals only
Many severe pneumonia progresses to critical ARDS
during treatment.
Treatment for ARDS has been developed over the years and still has a high mortality rate
.
This article reports a COVID-19-positive patient with overweight ARDS with early onset of severe hypoxia that is difficult to correct, combined with mechanical ventilation, muscle relaxation sedation, and prone positioning to treat early severe respiratory failure
.
: recurrent fever for 3 days, unconsciousness for 12 hours
.
▌History of present illness
The patient's family complained: the patient had fever 3 days before admission, the highest body temperature was 39 °C, the spirit was poor, no special treatment was given, there was no obvious cause at noon on the day of admission to appear unconscious, limb weakness, should not breathe, accompanied by urinary incontinence, denial of unilateral limb weakness, convulsions, denial of fever, hemoptysis, denial of increased frequency of stool, blood in the stool, black stool, denial of frequent urination, urgency, difficulty urinating
.
The family 120 ambulance was sent to the local hospital to improve the diagnosis after the relevant examinations: heart failure, coronary heart disease, and symptomatic treatment
such as strong heart and anti-heart failure.
Due to the positive nucleic acid of the new crown, the hospital was transferred to the red code hospital for further treatment, and then sent to the emergency department of our hospital, with 28 breaths per minute of physical examination, blood pressure of 61/29mmHg, and immediately given endotracheal intubation ventilator-assisted ventilation, "dopamine" pressurization, fluid replacement and other symptomatic treatment
.
Emergency complete head CT showed no bleeding, chest CT showed thickened texture in both lungs, ground-glass opacities and exudative shadows
in both lungs.
Income is for admission to hospital for further care
.
▌ History
of hypertension for more than 10 years, the highest blood pressure in the past is 180-190mmHg, long-term use of "amlodipine besylate" to control blood pressure, blood pressure control can be
。
The history of coronary heart disease is more than 10 years, and long-term use of "metoprolol" is symptomatic
.
In 2016, due to slow heart rate, a "dual-chamber pacemaker"
was implanted in the First Affiliated Hospital of Xinjiang Medical University.
▌Admission for body
temperature 36.
5C, pulse 110 times/min, blood pressure 66/45mmHg; Severe obesity, height 162cm, weight about 90Kg, BMI 34.
3, acute face, indifferent expression, passive position, mental coma, uncooperative
examination.
Tracheal intubation is brought in, and there is no yellow staining, rash and bleeding point on the skin and mucous membranes of the whole body
.
There is no sense of resistance in the neck, large and equal circles such as double pupils, and dull
light reflexes.
Breath sounds are coarse in both lungs, scattered crackles can be heard in both lungs, the abdomen is soft, both lower limbs are not swollen, and bilateral pathological signs are negative
.
In endotracheal intubation ventilator support, FiO2 100%, PEEP 8 cmH2O, F22times/min, V 320ml
.
The ventilator indicates a peak pressure of 45 cmH2O.
ECG monitoring: HR 110 beats/minute, SPO278%, RR 32 beats/minute, BP 66/45mmHg
.
▌Auxiliary examination
Multiple patchy exudation of both lungs during CT admission, partial consolidation in the middle lobe of the right lung, lingual lobe of the left lung and lower lobe of both lungs, and inflated bronchial signs can be seen in it
。
Admission blood gas analysis (2022.
11.
1): pH 7.
22, PO 2 46mmHg, PCO 245mmHg, BE-9.
1mmol/l
。
Admission blood routine (2022.
11.
1): white blood cell count 1.
87x 10 9, neutrophil percentage 82.
9%, lymphocyte count: 0.
20x109
.
The new crown nucleic acid CT value is 25.
22
.
PCT（2022.
11.
1）＞100 IL-6＞5000（pg/ml）
。
▌Admission to the hospital to diagnose
community-acquired pneumonia (severe), septic shock, respiratory failure, Coronary atherosclerotic heart disease, chronic
cardiac insufficiency, acute exacerbations, cardiac function class IV, sinus bradycardia, after pacemaker implantation, hypertensive disease class III (very high risk).
ECG monitoring at the time of ICU admission: HR 110 bpm, SPO278%, RR 32 bpm, BP 66/45mmHg
.
Vasoactive drugs are given immediately while fluid resuscitation maintains circulatory stability
.
Respiratory distress, cyanosis of the lips
.
In endotracheal intubation ventilator support, AC mode,FiO2100%, PEEP 8 cmH2O, F22 times/min, V 320 ml, ventilator peak pressure 45 cmH2O, lung compliance 10 ml/cmH2O.
PEEP was first upregulated and recruitment was attempted using PEEP incrementation
.
Pulse oxygen increases with PEEP upregulation, confirming remanoeuvre.
PEEP titration was given after pulmonary recruitment and the best PEEP was titrated to be about 18cmH2O; Sedative analgesic muscle relaxation
is given at the same time.
The patient's respiratory distress improved, and finger pulse oxygen increased from 78% to 88% at 100%
FiO2.
The patient is still unsatisfied with oxygenation and is ventilated prone to a prone position
.
After completing the prone position, SPO2 gradually increased from 88% to 93%
within 10 minutes.
With the increase of prone time, the patient's oxygenation and lung compliance were further improved, and after 20 hours to the prone position, the ventilator parameters were changed to PRVC mode, FiO270%, PEEP 18cmH2O, F 22 times/min, V320ml, at this time the peak pressure decreased from 45 to 38cmH2O, and the calculated compliance increased from 10 ml/cmH2 O rise to 20 ml/cmH2O.
After that, the patient was seated in the supine position for 4 hours and prone for 20 hours every day, for a total of 7 days in the prone position, and the patient's oxygenation and compliance gradually improved
.
After 7 days, the patient'sventilatorFiO2 had been adjusted down to 50%, PEEP 10cmH2O, lung compliance 35ml/cmH2O, prone oxygenation index maintained at 200mmHg, and 180mmHg remained in the supine position for 4 hours, so prone ventilation and sedation
were stopped.
The patient used meropenem plus linezolid to fight infection in the early stage, and the sputum culture result of bronchoscopy was Klebsiella pneumoniae, and linezolid was discontinued according to drug susceptibility adjustment, and meropenem alone was used to fight infection
.
After a series of treatments such as anti-infection, phlegm, nutritional support, and maintaining stable internal environment, the patient's vital signs gradually improved: the dose of vasoactive drugs was gradually reduced, and the acute renal dysfunction at admission was also significantly improved
.
After stopping sedation and analgesia, consciousness is restored and there is no neurological dysfunction
.
On November 14, the re-examination CT showed significant improvement, and the re-examination CT showed a little pleural effusion, and there was still atelectasis, but the lung function improved
.
The endotracheal tube was finally removed on 16 November
.
Treatment with non-invasive ventilation and high-flow oxygen is used after extubation
.
On 27 November, he was transferred out of the custody unit
.
The patient is positive for new crown nucleic acid, but due to the significant elevation of procalcitonin, ARDS
caused by new coronavirus and bacterial infection is considered.
Because of the high mortality rate of ARDS, its treatment has been the focus of
respiratory and critical care specialty research.
The CoVID-19 epidemic in recent years has brought more attention
to the diagnosis and treatment of ARDS.
This case treated a severely obese patient with severe pneumonia-related ARDS, and corrected the early severe hypoxia through various measures
.
The use
of obesity and ARDS, recruitment manoeuvre, and prone ventilation in ARDS is discussed here.
▌Severe obesity: Severe obesity
is a high risk factor
for the development of severe disease in a variety of diseases.
For ARDS, including COVID-19 virus-associated pneumonia, severe obesity is also an independent risk factor
for poor prognosis.
Causes include poor thoracic compliance, increased oxygen consumption, more pressure required for ventilator support (including inspiratory pressure and PEEP), and obesity-related poor ventilation syndromes
.
Higher ventilator pressures may cause ventilator-related damage to the lungs when used, and the solution is to measure transpulmonary pressure
.
At present, the common method of measuring trans-pneumonia is through esophageal measurement, intrathoracic pressure and then calculation of transpulmonary pressure, but the problem of esophageal pressure measurement consumables limits its application
.
In addition, severely obese patients showed more pronounced respiratory distress
when sedation was reduced and ventilator parameters were down-adjusted.
Possible causes are related
to obese patients who do more work on breathing, are more prone to disuse atrophy of respiratory muscles, and higher intrathoracic pressure are more prone to airway collapse.
For obese patients, weaning difficulties include 1) sequential weaning; 2) Tracheostomy
.
Tracheostomy reduces airway dead space and airway resistance, while aiding airway management and reducing the risk of
infection.
The patient had a BMI of 34.
3, was mechanically ventilated for 16 days, weaned by sequential method, gradually reduced the intensity of respiratory support, and finally succeeded in weaning
.
▌Pulmonary remanence
is an important ventilation method
for mechanical ventilation in patients with ARDS when severe hypoxia and atelectasis.
But controversy
arose after the publication of the JAMA [1] study in 2017.
Many people question the difference in PEEP between the two groups in this article by only1.
5 cmH2O, and suggest that the patients collected in the study did not assess the patient's lung reductability, believing that these two factors are the main reasons for the study to believe that the atelectasis is the main reason
.
At present, the mainstream believes that recruitment manoeuvres are still beneficial to many patients, but it is necessary to clarify which patients are suitable for recruitment manoeuvres before operation, that is, to determine remanoeuvres.
There are many methods of determination, including imaging methods, such as lung CT, pulmonary ultrasound, EIT, PET-CT, and functional evaluation, such as PV curve, end-expiratory lung volume, and pulmonary stretch index
.
However, the simplest and most effective method commonly used in clinical practice is to try a pulmonary recruitment to observe the improvement of oxygenation and lung compliance after re-opening
.
If improved, the patient may have better remanoeuvres.
It is important to note that if the patient's oxygenation does not improve after remanation, it is not necessarily poor remanation, as it is also necessary to take into account the lack of time and pressure for remanation, and the decrease in cardiac output due to hemodynamic changes during remanation and a decrease in oxygenation
.
This patient had good remanence, which led to improved oxygenation and compliance, and titrated PEEP, providing a basis for
early life-saving survival.
▌Prone ventilation Prone ventilation
is currently considered to be the most effective treatment for ARDS, which can significantly improve intrapulmonary shunts and improve oxygenation
.
Longer prone positions have been shown to be beneficial
in improving lung function.
In clinical practice, the active use of prone ventilation significantly reduces the use of
ECMO.
Prone positioning can be considered early in patients with ARDS, except in patients with severe hypoxia, and awake prone ventilation is encouraged in unintubated patients
.
In most patients, lung effusion gradually improves after maintaining the acute phase
.
The timing of switching from a conscious prone position to a sedative prone position after intubation is a topic faced by patients with severe ARDS and a hot
topic of current research.
At present, ROX index (SPO 2/FiO 2 xRR) is a more commonly used indicator for intubation in high-flow oxygen-induced patients [2].
For the index of prone position of intubation in noninvasive patients, a VOX index (SpO 2/FiO2 xVT) has recently been proposed [3].
THE PROSEVA STUDY CONFIRMED THAT PRONE TIME IS AT LEAST 16 HOURS
PER DAY.
The 9th edition of the new crown treatment expert consensus is at least 12 hours, under this premise as long
as possible to lie prone every day.
In addition, the well-accepted criterion for stopping prone therapy was also the criterion for PROSEVA studies: patients were at FiO2<60 percent, and PEEP<b217>< 10 cmH2O, P/F> 150, and remained in the supine position for more than four hours [4,5].
The patient was prone for 20 hours daily for 7 days, significantly improving hypoxia and avoiding ECMO
.
The use of ventilators for ARDS has always been difficult for mechanical ventilation, and the strategies of small tidal volume, low plateau pressure, and permissive hypercapnia have been agreed
.
How to choose the right PEEP is a hot topic of research, and it is also very controversial
whether to perform recruitment manoeuvre.
The patient's pulmonary recruitment was effective, appropriate PEEP was obtained by titration, and the patient's oxygenation and ventilation dynamics were improved
.
Additional measures of clear benefit to patients are the use
of sedative muscle relaxation and prone position.
The former reduces oxygen consumption, reduces lung damage (SILI) caused by spontaneous breathing, and lays the foundation for
prone position.
The prone position significantly improves the pathological changes of the lungs and improves oxygenation
.
The difficulty in this patient is obesity, which increases the difficulty of adjusting the ventilator and subsequent weaning, and the prone
position.
Overall, the patient's success is the result of a combination of
measures.
Expert profile Liu Yang
Expert profiles
More respiratory classics?
Come to the "Doctor Station Web Version" and take a look 👇
Ruijin Respiratory Detective Room, take you to analyze breathing classic cases!
Many severe pneumonia progresses to critical ARDS
during treatment.
Treatment for ARDS has been developed over the years and still has a high mortality rate
.
This article reports a COVID-19-positive patient with overweight ARDS with early onset of severe hypoxia that is difficult to correct, combined with mechanical ventilation, muscle relaxation sedation, and prone positioning to treat early severe respiratory failure
.
Case Profile
: recurrent fever for 3 days, unconsciousness for 12 hours
.
▌History of present illness
The patient's family complained: the patient had fever 3 days before admission, the highest body temperature was 39 °C, the spirit was poor, no special treatment was given, there was no obvious cause at noon on the day of admission to appear unconscious, limb weakness, should not breathe, accompanied by urinary incontinence, denial of unilateral limb weakness, convulsions, denial of fever, hemoptysis, denial of increased frequency of stool, blood in the stool, black stool, denial of frequent urination, urgency, difficulty urinating
.
The family 120 ambulance was sent to the local hospital to improve the diagnosis after the relevant examinations: heart failure, coronary heart disease, and symptomatic treatment
such as strong heart and anti-heart failure.
Due to the positive nucleic acid of the new crown, the hospital was transferred to the red code hospital for further treatment, and then sent to the emergency department of our hospital, with 28 breaths per minute of physical examination, blood pressure of 61/29mmHg, and immediately given endotracheal intubation ventilator-assisted ventilation, "dopamine" pressurization, fluid replacement and other symptomatic treatment
.
Emergency complete head CT showed no bleeding, chest CT showed thickened texture in both lungs, ground-glass opacities and exudative shadows
in both lungs.
Income is for admission to hospital for further care
.
▌ History
of hypertension for more than 10 years, the highest blood pressure in the past is 180-190mmHg, long-term use of "amlodipine besylate" to control blood pressure, blood pressure control can be
。
The history of coronary heart disease is more than 10 years, and long-term use of "metoprolol" is symptomatic
.
In 2016, due to slow heart rate, a "dual-chamber pacemaker"
was implanted in the First Affiliated Hospital of Xinjiang Medical University.
▌Admission for body
temperature 36.
5C, pulse 110 times/min, blood pressure 66/45mmHg; Severe obesity, height 162cm, weight about 90Kg, BMI 34.
3, acute face, indifferent expression, passive position, mental coma, uncooperative
examination.
Tracheal intubation is brought in, and there is no yellow staining, rash and bleeding point on the skin and mucous membranes of the whole body
.
There is no sense of resistance in the neck, large and equal circles such as double pupils, and dull
light reflexes.
Breath sounds are coarse in both lungs, scattered crackles can be heard in both lungs, the abdomen is soft, both lower limbs are not swollen, and bilateral pathological signs are negative
.
In endotracheal intubation ventilator support, FiO2 100%, PEEP 8 cmH2O, F22times/min, V 320ml
.
The ventilator indicates a peak pressure of 45 cmH2O.
ECG monitoring: HR 110 beats/minute, SPO278%, RR 32 beats/minute, BP 66/45mmHg
.
▌Auxiliary examination
Multiple patchy exudation of both lungs during CT admission, partial consolidation in the middle lobe of the right lung, lingual lobe of the left lung and lower lobe of both lungs, and inflated bronchial signs can be seen in it
。
Admission blood gas analysis (2022.
11.
1): pH 7.
22, PO 2 46mmHg, PCO 245mmHg, BE-9.
1mmol/l
。
Admission blood routine (2022.
11.
1): white blood cell count 1.
87x 10 9, neutrophil percentage 82.
9%, lymphocyte count: 0.
20x109
.
The new crown nucleic acid CT value is 25.
22
.
PCT（2022.
11.
1）＞100 IL-6＞5000（pg/ml）
。
▌Admission to the hospital to diagnose
community-acquired pneumonia (severe), septic shock, respiratory failure, Coronary atherosclerotic heart disease, chronic
cardiac insufficiency, acute exacerbations, cardiac function class IV, sinus bradycardia, after pacemaker implantation, hypertensive disease class III (very high risk).
Treatment process
ECG monitoring at the time of ICU admission: HR 110 bpm, SPO278%, RR 32 bpm, BP 66/45mmHg
.
Vasoactive drugs are given immediately while fluid resuscitation maintains circulatory stability
.
Respiratory distress, cyanosis of the lips
.
In endotracheal intubation ventilator support, AC mode,FiO2100%, PEEP 8 cmH2O, F22 times/min, V 320 ml, ventilator peak pressure 45 cmH2O, lung compliance 10 ml/cmH2O.
PEEP was first upregulated and recruitment was attempted using PEEP incrementation
.
Pulse oxygen increases with PEEP upregulation, confirming remanoeuvre.
PEEP titration was given after pulmonary recruitment and the best PEEP was titrated to be about 18cmH2O; Sedative analgesic muscle relaxation
is given at the same time.
The patient's respiratory distress improved, and finger pulse oxygen increased from 78% to 88% at 100%
FiO2.
The patient is still unsatisfied with oxygenation and is ventilated prone to a prone position
.
After completing the prone position, SPO2 gradually increased from 88% to 93%
within 10 minutes.
With the increase of prone time, the patient's oxygenation and lung compliance were further improved, and after 20 hours to the prone position, the ventilator parameters were changed to PRVC mode, FiO270%, PEEP 18cmH2O, F 22 times/min, V320ml, at this time the peak pressure decreased from 45 to 38cmH2O, and the calculated compliance increased from 10 ml/cmH2 O rise to 20 ml/cmH2O.
After that, the patient was seated in the supine position for 4 hours and prone for 20 hours every day, for a total of 7 days in the prone position, and the patient's oxygenation and compliance gradually improved
.
After 7 days, the patient'sventilatorFiO2 had been adjusted down to 50%, PEEP 10cmH2O, lung compliance 35ml/cmH2O, prone oxygenation index maintained at 200mmHg, and 180mmHg remained in the supine position for 4 hours, so prone ventilation and sedation
were stopped.
The patient used meropenem plus linezolid to fight infection in the early stage, and the sputum culture result of bronchoscopy was Klebsiella pneumoniae, and linezolid was discontinued according to drug susceptibility adjustment, and meropenem alone was used to fight infection
.
After a series of treatments such as anti-infection, phlegm, nutritional support, and maintaining stable internal environment, the patient's vital signs gradually improved: the dose of vasoactive drugs was gradually reduced, and the acute renal dysfunction at admission was also significantly improved
.
After stopping sedation and analgesia, consciousness is restored and there is no neurological dysfunction
.
On November 14, the re-examination CT showed significant improvement, and the re-examination CT showed a little pleural effusion, and there was still atelectasis, but the lung function improved
.
The endotracheal tube was finally removed on 16 November
.
Treatment with non-invasive ventilation and high-flow oxygen is used after extubation
.
On 27 November, he was transferred out of the custody unit
.
discuss
The patient is positive for new crown nucleic acid, but due to the significant elevation of procalcitonin, ARDS
caused by new coronavirus and bacterial infection is considered.
Because of the high mortality rate of ARDS, its treatment has been the focus of
respiratory and critical care specialty research.
The CoVID-19 epidemic in recent years has brought more attention
to the diagnosis and treatment of ARDS.
This case treated a severely obese patient with severe pneumonia-related ARDS, and corrected the early severe hypoxia through various measures
.
The use
of obesity and ARDS, recruitment manoeuvre, and prone ventilation in ARDS is discussed here.
▌Severe obesity: Severe obesity
is a high risk factor
for the development of severe disease in a variety of diseases.
For ARDS, including COVID-19 virus-associated pneumonia, severe obesity is also an independent risk factor
for poor prognosis.
Causes include poor thoracic compliance, increased oxygen consumption, more pressure required for ventilator support (including inspiratory pressure and PEEP), and obesity-related poor ventilation syndromes
.
Higher ventilator pressures may cause ventilator-related damage to the lungs when used, and the solution is to measure transpulmonary pressure
.
At present, the common method of measuring trans-pneumonia is through esophageal measurement, intrathoracic pressure and then calculation of transpulmonary pressure, but the problem of esophageal pressure measurement consumables limits its application
.
In addition, severely obese patients showed more pronounced respiratory distress
when sedation was reduced and ventilator parameters were down-adjusted.
Possible causes are related
to obese patients who do more work on breathing, are more prone to disuse atrophy of respiratory muscles, and higher intrathoracic pressure are more prone to airway collapse.
For obese patients, weaning difficulties include 1) sequential weaning; 2) Tracheostomy
.
Tracheostomy reduces airway dead space and airway resistance, while aiding airway management and reducing the risk of
infection.
The patient had a BMI of 34.
3, was mechanically ventilated for 16 days, weaned by sequential method, gradually reduced the intensity of respiratory support, and finally succeeded in weaning
.
▌Pulmonary remanence
is an important ventilation method
for mechanical ventilation in patients with ARDS when severe hypoxia and atelectasis.
But controversy
arose after the publication of the JAMA [1] study in 2017.
Many people question the difference in PEEP between the two groups in this article by only1.
5 cmH2O, and suggest that the patients collected in the study did not assess the patient's lung reductability, believing that these two factors are the main reasons for the study to believe that the atelectasis is the main reason
.
At present, the mainstream believes that recruitment manoeuvres are still beneficial to many patients, but it is necessary to clarify which patients are suitable for recruitment manoeuvres before operation, that is, to determine remanoeuvres.
There are many methods of determination, including imaging methods, such as lung CT, pulmonary ultrasound, EIT, PET-CT, and functional evaluation, such as PV curve, end-expiratory lung volume, and pulmonary stretch index
.
However, the simplest and most effective method commonly used in clinical practice is to try a pulmonary recruitment to observe the improvement of oxygenation and lung compliance after re-opening
.
If improved, the patient may have better remanoeuvres.
It is important to note that if the patient's oxygenation does not improve after remanation, it is not necessarily poor remanation, as it is also necessary to take into account the lack of time and pressure for remanation, and the decrease in cardiac output due to hemodynamic changes during remanation and a decrease in oxygenation
.
This patient had good remanence, which led to improved oxygenation and compliance, and titrated PEEP, providing a basis for
early life-saving survival.
▌Prone ventilation Prone ventilation
is currently considered to be the most effective treatment for ARDS, which can significantly improve intrapulmonary shunts and improve oxygenation
.
Longer prone positions have been shown to be beneficial
in improving lung function.
In clinical practice, the active use of prone ventilation significantly reduces the use of
ECMO.
Prone positioning can be considered early in patients with ARDS, except in patients with severe hypoxia, and awake prone ventilation is encouraged in unintubated patients
.
In most patients, lung effusion gradually improves after maintaining the acute phase
.
The timing of switching from a conscious prone position to a sedative prone position after intubation is a topic faced by patients with severe ARDS and a hot
topic of current research.
At present, ROX index (SPO 2/FiO 2 xRR) is a more commonly used indicator for intubation in high-flow oxygen-induced patients [2].
For the index of prone position of intubation in noninvasive patients, a VOX index (SpO 2/FiO2 xVT) has recently been proposed [3].
THE PROSEVA STUDY CONFIRMED THAT PRONE TIME IS AT LEAST 16 HOURS
PER DAY.
The 9th edition of the new crown treatment expert consensus is at least 12 hours, under this premise as long
as possible to lie prone every day.
In addition, the well-accepted criterion for stopping prone therapy was also the criterion for PROSEVA studies: patients were at FiO2<60 percent, and PEEP<b217>< 10 cmH2O, P/F> 150, and remained in the supine position for more than four hours [4,5].
The patient was prone for 20 hours daily for 7 days, significantly improving hypoxia and avoiding ECMO
.
The use of ventilators for ARDS has always been difficult for mechanical ventilation, and the strategies of small tidal volume, low plateau pressure, and permissive hypercapnia have been agreed
.
How to choose the right PEEP is a hot topic of research, and it is also very controversial
whether to perform recruitment manoeuvre.
The patient's pulmonary recruitment was effective, appropriate PEEP was obtained by titration, and the patient's oxygenation and ventilation dynamics were improved
.
Additional measures of clear benefit to patients are the use
of sedative muscle relaxation and prone position.
The former reduces oxygen consumption, reduces lung damage (SILI) caused by spontaneous breathing, and lays the foundation for
prone position.
The prone position significantly improves the pathological changes of the lungs and improves oxygenation
.
The difficulty in this patient is obesity, which increases the difficulty of adjusting the ventilator and subsequent weaning, and the prone
position.
Overall, the patient's success is the result of a combination of
measures.
Expert profile Liu Yang
- Doctor of Medicine, Deputy Chief Physician, Master Supervisor
- Leader of Group C of the Shanghai Intensive Care Medical Team to Xinjiang
- Deputy Director of the Department of Critical Care Medicine, Shanghai Dongfang Hospital
- Youth Committee Member of Critical Care Medicine Branch of Shanghai Medical Association,
- Youth Committee Member of Blood Transfusion Branch of Shanghai Medical Association
- Youth Committee Member of Critical Care Medicine Branch of Pudong New Area Medical Association
- National Committee Member of the Simulation Medicine Department of Wu Jieping Medical Foundation
- Member of the American Association of Respiratory Therapy
Expert profiles
Xie Hui
- Xie Hui, Deputy Director of the Emergency and Critical Care Department of Shanghai First People's Hospital, Chief Physician, Master Supervisor
. - Captain of the Shanghai Aid Xinjiang Intensive Care Medical Team
- Vice Chairman of the Youth Committee of the Critical Care Branch of Shanghai Medical Association
- Visiting scholar at Rabin Medical Center Tel Aviv, Israel
- He presided over 2 projects of the National Natural Science Foundation of China
.
Shen Lei
- Doctor of Medicine, Deputy Chief Physician, Department of Infectious Diseases, Huashan Hospital, Fudan University
- Deputy leader of Group C of the Shanghai Intensive Care Medical Team to Xinjiang
- Member of the Anesthesia Professional Committee of Shanghai Association of Social Medical Institutions
- Visiting scholar at Karolinska Institutet, Sweden
- 2020 Shanghai Pujiang Talents
- He presided over one project of the National Natural Science Foundation of China
- He has published more than 10 SCI articles and participated in the editing of 3 monographs
Feng Yun
- Chief physician of the Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and tutor of master's students
- Deputy leader of Group A of the Shanghai Intensive Care Medical Team to Xinjiang
- Visiting scholar at Duke University
- Member and Secretary of the Youth Committee of the Respiratory Branch of Shanghai Medical Association
- Deputy leader of the Critical Care Group of the Respiratory Branch of Shanghai Medical Association
- He has won the Shanghai Talent Training Program, Shanghai Excellent Specialist and Shanghai Jiao Tong University School of Medicine Kowloon Medical Award, won the National Natural Science Foundation of China and the National Key R&D Program sub-project funding, published more than 30 relevant SCI articles as the first author and corresponding author, 2 patents of the first completer, participated in the compilation of 3 professional books, and won the first prize of Shanghai Science and Technology Progress Award
.
Muyesai Nigati
Muyesai Nigati is an expert with special allowance of the State Council, chief physician, professor, postdoctoral fellow, and doctoral supervisor
He is currently the director of the emergency center of Xinjiang Uygur Autonomous Region People's Hospital, the director of the Xinjiang Emergency Quality Control Center, and the director of the Xinjiang Emergency Research Institute
He has long been engaged in clinical and basic research in cardiovascular acute and critical diseases, resuscitation and interventional diagnosis and treatment of coronary heart disease
Member of the Precision Medicine Group of the Cardiovascular Disease Branch of the Chinese Medical Association, member of the Emergency Medicine Branch of the Chinese Medical Association, member of the Heart Failure Professional Committee of the Chinese Medical Doctor Association, and member of the Heart Failure Branch of the National Cardiovascular Disease Expert Committee
He has undertaken more than 10 national and provincial projects, published more than 50 core scientific research papers, including more than 10 SCI papers, edited and co-edited 5 monographs, and trained more than 20 master's students
More respiratory classics?
Come to the "Doctor Station Web Version" and take a look 👇
