From the Guidelines
Inpatient management for Liguria is not directly addressed in the provided evidence, and therefore, a definitive recommendation cannot be made based on the given studies. However, considering the context of inpatient management for hematological conditions, the following general principles can be applied:
- Management of acute leukemia, including acute myeloblastic leukemia (AML) and acute promyelocytic leukemia (APL), requires a multidisciplinary approach in a center with adequate infrastructure and expertise 1.
- Supportive care is essential, including transfusions, management of coagulopathy, and prevention of infections 1.
- For APL, treatment with all-trans retinoic acid (ATRA) should be started immediately, and transfusions of fibrinogen, platelets, and fresh-frozen plasma should be given to maintain adequate coagulation parameters 1.
- In the context of the COVID-19 pandemic, consideration should be given to minimizing the risk of contracting SARS-CoV-2 and reducing the severity of ensuing COVID-19 for patients by avoiding healthcare exposure and periods of immunosuppression 1. Some key points to consider in the management of hematological conditions include:
- The importance of a multidisciplinary team approach in a center with adequate infrastructure and expertise 1.
- The need for supportive care, including transfusions and management of coagulopathy 1.
- The importance of minimizing the risk of contracting SARS-CoV-2 and reducing the severity of ensuing COVID-19 for patients by avoiding healthcare exposure and periods of immunosuppression 1. It is essential to note that the provided evidence does not directly address the management of Liguria, and therefore, these general principles may not be directly applicable. A definitive recommendation for inpatient management of Liguria cannot be made based on the given studies, and further research or consultation with a specialist is necessary.
From the Research
Inpatient Management for Liguria
There is no direct evidence related to inpatient management for Liguria. However, we can discuss general inpatient management strategies for COVID-19 patients, which may be relevant to Liguria.
Oxygen Therapy
- Oxygen therapy is a crucial aspect of inpatient management for COVID-19 patients, as it helps to address hypoxia and improve oxygen saturation 2.
- The goal of oxygen therapy is to maintain an oxygen saturation level between 94-98% for most hospitalized patients, and 88-92% for those with COPD 3.
- High-flow oxygen therapy may be considered for patients who require high levels of oxygen, as it can help to reduce the need for intubation and improve patient outcomes 3.
Risk Assessment
- Vital signs, such as body temperature, respiratory rate, and oxygen saturation, can be used to predict the need for oxygen therapy in COVID-19 patients 4.
- A risk score based solely on vital signs can effectively assess the likelihood of requiring oxygen therapy within seven days, with high accuracy 4.
- Factors such as advanced age, increased respiratory rate, decreased oxygen saturation, and the presence of pneumonia on CT scans are significant predictors of oxygen need among COVID-19 patients 4.
Infection Control
- Health care workers face a significant risk of infection when treating patients with severe acute respiratory infection, and oxygen therapy modalities can generate air dispersion and increase the risk of infection 5.
- The lowest flow of oxygen should be used to maintain an adequate oxygen saturation for patients with severe acute respiratory infection, and manipulation of oxygen delivery equipment should be minimized 5.
Decision-Making
- For incapacitated patients without proxies, a protocol involving community volunteers to make decisions can be feasible and ethically defensible 6.
- A standard of "informed best interest" can be used to make decisions for patients without proxies, and agreement can be reached with attending physicians 6.