Cai S J, Wu L L, Chen D F, Li Y X, Liu Y J, Fan Y Q, Du S H, Huang H, Liu N, Cheng L L, Deng X L, Li S Y
Intensive Care Unit, Guangzhou 8th People's Hospital, Guangzhou 440111, China.
Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory, Guangzhou Institute of Respiratory Disease, Guangzhou 510120, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2020 Apr 12;43(4):332-334. doi: 10.3760/cma.j.cn112147-20200222-00153.
Endotracheal intubation is an independent risk factor for respiratory infectious diseases. We conducted a retrospective study in 12 cases with COVID-19 who underwent endotracheal intubation at ICU of the Guangzhou eighth hospital from January 20 to February 10, 2020. The intubation procedure, anesthetic regimen, and complication were collected and analyzed. The 9 healthcare workers who involved in intubation received virus nucleic acid test and 14 days temperature monitoring. All 12 patients were successfully intubated under the guidance of bronchoscope, without any complications. Midazolam, Propofol and Morphine or fentanyl were used for sedation and analgesia, avoiding patients cough and agitated during the procedure. The 9 healthcare workers were protected under the Personal Protective Equipment(PPE) with positive pressure protective hood. The detection of oropharyngeal swab virus nucleic acid were negative in all 9 healthcare workers, none of them had fever or any respiratory symptoms. The PPE with positive pressure protective hood should be needed to perform bronchoscope-guided endotracheal intubation in patients with COVID-19, it could strengthen to protect healthcare workers from virus exposure.
气管插管是呼吸道传染病的独立危险因素。我们对2020年1月20日至2月10日在广州市第八人民医院重症监护室接受气管插管的12例新冠肺炎患者进行了回顾性研究。收集并分析了插管过程、麻醉方案及并发症情况。参与插管的9名医护人员接受了病毒核酸检测及14天体温监测。12例患者均在支气管镜引导下成功插管,无任何并发症。使用咪达唑仑、丙泊酚和吗啡或芬太尼进行镇静镇痛,避免患者在操作过程中咳嗽和躁动。9名医护人员在穿戴带有正压防护头罩的个人防护装备(PPE)下得到保护。9名医护人员的咽拭子病毒核酸检测均为阴性,均未发热或出现任何呼吸道症状。对新冠肺炎患者进行支气管镜引导下气管插管时应使用带有正压防护头罩的PPE,可加强对医护人员的病毒暴露防护。