Managing multi-organ dysfunction of COVID-19

Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, Chief Nurse of Wolters Kluwer Health Learning, Research & Practice, adjunct faculty for Drexel University, and a critical care nurse practitioner for Penn Medicine, Chester County Hospital, and Collette Hendler, RN, MS, MA, CIC, Editor-in-Chief for Lippincott Solutions and certified by the Certification Board of Infection Control and Epidemiology, Inc. as an Infection Preventionist, answer questions related to managing multiorgan dysfunction in COVID-19 patients. These questions were submitted by attendees of the webcast, Calming the COVID-19 Storm: Delivering Effective Clinical and Nursing Care, which took place on May 7, 2020. This podcast covers the following questions: I have heard that the inflammatory response is responsible for the multi-system effects of COVID. What is the cytokine storm? I heard that patients with COVID-19 develop a coagulopathy and have excessive clotting. How do you manage their clotting and why is this so important? Do COVID-19 patients also have bleeding issues besides clotting issues? I hear patients are discharged on anticoagulation; how long are they on lovenox and what is the dose? Have you noticed COVID positive patients going into a new onset rapid a fib? If a patient presents with heart failure due to COVID, will the ejection fraction be affected? Is there a role of aspirin in the early stages of covid-19? Can you review the difference of CRRT, SLEDD and PIRRT? How do you keep the circuit from clotting? Is peritoneal dialysis helpful for acute kidney injury associated with COVID-19 or only CRRT or hemodialysis? Do you have any information about the use of Actemra in COVID-19? *Note: this podcast was recorded on May 19, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you'll find links to the on-demand webcast (earn 1 free contact hour!), CDC and WHO, plus free access to our point-of-care tools and more.