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COVID-19 感染患者在急诊手术期间的麻醉管理。

Anesthetic Management of Patients with COVID 19 Infections during Emergency Procedures.

机构信息

Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Department of Anesthesiology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Anesthesiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

J Cardiothorac Vasc Anesth. 2020 May;34(5):1125-1131. doi: 10.1053/j.jvca.2020.02.039. Epub 2020 Feb 28.

Abstract

OBJECTIVES

The aim of the present study was to prevent cross-infection in the operating room during emergency procedures for patients with confirmed or suspected 2019 novel coronavirus (2019-nCoV) by following anesthesia management protocols, and to document clinical- and anesthesia-related characteristics of these patients.

DESIGN

This was a retrospective, multicenter clinical study.

SETTING

This study used a multicenter dataset from 4 hospitals in Wuhan, China.

PARTICIPANTS

Patients and health care providers with confirmed or suspected 2019-nCoV from January 23 to 31, 2020, at the Wuhan Union Hospital, the Wuhan Children's Hospital, The Central Hospital of Wuhan, and the Wuhan Fourth Hospital in Wuhan, China.

INTERVENTIONS

Anesthetic management and infection control guidelines for emergency procedures for patients with suspected 2019-nCoV were drafted and applied in 4 hospitals in Wuhan.

MEASUREMENTS AND MAIN RESULTS

Cross-infection in the operating rooms of the 4 hospitals was effectively reduced by implementing the new measures and procedures. The majority of patients with laboratory-confirmed 2019-nCoV infection or suspected infection were female (23 [62%] of 37), and the mean age was 41.0 years old (standard deviation 19.6; range 4-78). 10 (27%) patients had chronic medical illnesses, including 4 (11%) with diabetes, 8 (22%) with hypertension, and 8 (22%) with digestive system disease. Twenty-five (68%) patients presented with lymphopenia, and 23 (62%) patients exhibited multiple mottling and ground-glass opacity on computed tomography scanning.

CONCLUSIONS

The present study indicates that COVID 19-specific guidelines for emergency procedures for patients with confirmed or suspected 2019-nCoV may effectively prevent cross-infection in the operating room. Most patients with confirmed or suspected COVID 19 presented with fever and dry cough and demonstrated bilateral multiple mottling and ground-glass opacity on chest computed tomography scans.

摘要

目的

本研究旨在通过遵循麻醉管理方案,预防手术室在对确诊或疑似 2019 新型冠状病毒(2019-nCoV)的患者进行紧急手术时发生交叉感染,并记录这些患者的临床和麻醉相关特征。

设计

这是一项回顾性、多中心临床研究。

地点

本研究使用了来自中国武汉 4 家医院的多中心数据集。

参与者

2020 年 1 月 23 日至 31 日,在中国武汉的武汉协和医院、武汉儿童医院、武汉市中心医院和武汉市第四医院,对确诊或疑似 2019-nCoV 的患者和医护人员。

干预措施

为疑似 2019-nCoV 患者的紧急手术制定并实施了麻醉管理和感染控制指南。

测量和主要结果

通过实施新措施和程序,有效减少了 4 家医院手术室的交叉感染。大多数实验室确诊的 2019-nCoV 感染或疑似感染患者为女性(37 例中的 23 例,62%),平均年龄为 41.0 岁(标准差 19.6;范围 4-78)。10 例(27%)患者患有慢性疾病,包括 4 例(11%)糖尿病、8 例(22%)高血压和 8 例(22%)消化系统疾病。25 例(68%)患者出现淋巴细胞减少症,23 例(62%)患者在计算机断层扫描上显示多发斑点状和磨玻璃样混浊。

结论

本研究表明,针对确诊或疑似 2019-nCoV 患者的紧急手术的 COVID-19 特定指南可能有效预防手术室交叉感染。大多数确诊或疑似 COVID-19 的患者表现出发热和干咳,并在胸部计算机断层扫描上显示双侧多发性斑点状和磨玻璃样混浊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7353/7102598/b9575c5c6fa6/gr1_lrg.jpg

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