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新型冠状病毒肺炎（COVID-19）在武汉感染流行并迅速蔓延至全国，部分病例可发生急性呼吸窘迫综合征（acute respiratory distress syndrome，ARDS），甚至引起死亡。在此我们结合一线的救治体会，给大家分享危重型NCP的治疗经验。需选择最佳呼吸支持方式，但气管插管时机的把握及插管时的防护是两个难点；高水平呼气末正压通气（PEEP）、俯卧位效果不佳的患者可行体外膜氧合（ECMO）支持。对于机械通气的NCP患者，制定合理的镇静镇痛策略，谵妄不容忽视。此外，危重型COVID-19患者体内存在炎性因子的上调，但肾脏替代治疗的效果还需临床研究进一步证实。“,”COVID-19 has been prevalent in Wuhan and spread rapidly to all of our country. Some cases can develop into ARDS, or even death. We will share the treatment experience of severe COVID-19 with the first-line treatment experience. The best respiratory support mode should be selected, but the timing of intubation and protection during intubation are two difficulties; patients with high level peep and poor effect in prone position can be given ECMO support. For COVID-19 patients with mechanical ventilation, reasonable sedation and analgesia strategies should be formulated; delirium should not be ignored. In addition, there is up regulation of inflammatory factors in patients with severe COVID-19, but the effect of renal replacement therapy needs to be further confirmed by clinical research.