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In order to further improve the medical treatment of severe cases of novel coronavirus infection and effectively improve the level of standardized and homogeneous diagnosis and treatment, the National Health Commission and the State Administration of Traditional Chinese Medicine, combined with the characteristics of the Omicron variant and the characteristics of the diseases of infected people, summarized the previous medical treatment work experience, organized the revision of the "Diagnosis and Treatment Plan for Severe and Critical Cases of Novel Coronavirus Pneumonia (Trial Third Edition)", and formed the "Diagnosis and Treatment Plan for Severe Cases of Novel Coronavirus Infection (Trial Fourth Edition)" (hereinafter referred to as the "Plan")
。 The key revisions are as follows:
1.
Adjust the name of the disease
Adjust "novel coronavirus pneumonia" to "new coronavirus infection"
.
Second, the threshold is moved forward to strengthen the clinical early warning of severe disease
The Plan further clarifies the high-risk groups for severe disease, and patients with new coronavirus pneumonia who do not meet the diagnostic criteria for severe disease, but are > 65 years old, have not completed full vaccination, and have more serious chronic diseases, can be managed
as severe cases.
Vital signs monitoring of people at high risk of severe disease, especially finger oxygen saturation at rest and after activity; Emphasizing the role of hypoxia in the early warning of severe clinical disease, oxygen saturation < 94% after mild activity, and the deterioration
of the condition should be alerted.
III.
Incorporate effective treatments in clinical practice into the Plan
Symptomatic management such as hyperthermia and cough is added to general treatment; In the antiviral treatment, small molecule drugs that have been approved for marketing in China have been added; Added anticoagulant therapy; emphasized the importance of awake prone ventilation; In terms of oxygen therapy and respiratory support therapy, combined with the latest understanding and research evidence, it is pointed out that nasal high-flow oxygen therapy is superior to nasal cannula or mask oxygen, improves the setting method of positive end-expiratory pressure (PEEP), and strengthens lung protection measures
for mechanical ventilation.
4.
Revise and improve the treatment part of traditional Chinese medicine
Some symptom types and the content of "combined treatment of disease symptoms" have been added, and the clinical treatment guidance of integrated traditional Chinese and Western medicine for severe and critical cases has been strengthened, so as to better give play to the characteristic advantages of
traditional Chinese medicine.
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