Reed Laura K, Wen Jun, Liang Buqing, Wang Xiangyu, Feng Dongxia, Huang Jason H
Department of Neurosurgery, Baylor Scott & White Medical Center , Temple, TX, USA.
Department of Surgery, Texas A&M University College of Medicine , Temple, TX, USA.
Neurol Res. 2020 Oct;42(10):811-817. doi: 10.1080/01616412.2020.1781455. Epub 2020 Jul 1.
The novel coronavirus disease (COVID-19) pandemic poses a substantial threat to the health of healthcare personnel on the front line of caring for COVID-19 patients. The Centers for Medicare and Medicaid Services previously announced that all non-essential planned surgeries and procedures should be postponed until further notice and only urgent procedures should proceed.
We share our experiences with safely performing neurosurgical procedures on confirmed and suspected COVID-19 patients, to aide other neurosurgical teams in preparing for these high-risk cases, especially for neurosurgical interventions which are essential at saving a life or preserving functioning of the central nervous system that cannot be delayed. Perioperative and intraoperative strategies, considerations, as well as challenges arisen under the specific circumstance have been discussed: the hospital should be equipped with negative pressure areas and multiple areas to quarantine positive patients; the operating rooms should be negative pressure or have HEPA-filtration systems in place; all healthcare personnel who immediately participate in neurosurgical interventions for confirmed and suspected COVID-19 patients should take airborne precautions and wear enhanced personal protective equipment.
Successful management of neurosurgical emergencies without healthcare personnel infection has been achieved during this pandemic crisis.
Following the proposed guidance, urgent neurosurgical surgeries and procedures can be safely performed for the benefit of critical patients with or suspected for COVID-19.
新型冠状病毒病(COVID-19)大流行对护理COVID-19患者的一线医护人员的健康构成了重大威胁。美国医疗保险和医疗补助服务中心此前宣布,所有非必要的计划性手术和操作应推迟至另行通知,仅应进行紧急操作。
我们分享在确诊和疑似COVID-19患者身上安全进行神经外科手术的经验,以帮助其他神经外科团队为这些高风险病例做好准备,特别是对于挽救生命或维持中枢神经系统功能不可或缺且不能延迟的神经外科干预。讨论了围手术期和术中策略、注意事项以及在特定情况下出现的挑战:医院应配备负压区域和多个隔离阳性患者的区域;手术室应为负压或配备高效空气过滤器系统;所有直接参与确诊和疑似COVID-19患者神经外科干预的医护人员应采取空气传播预防措施并穿戴强化个人防护装备。
在这场大流行危机期间,已成功处理神经外科紧急情况且未发生医护人员感染。
遵循所提议的指导原则,可为患有或疑似患有COVID-19的重症患者安全地进行紧急神经外科手术和操作。