Atrium Health, University of North Carolina, Charlotte, North Carolina, USA.
Augusta University, Augusta, Georgia, USA.
Am J Gastroenterol. 2020 Oct;115(10):1575-1583. doi: 10.14309/ajg.0000000000000823.
The American Neurogastroenterology and Motility Society Task Force recommends that gastrointestinal motility procedures should be performed in motility laboratories adhering to the strict recommendations and personal protective equipment (PPE) measures to protect patients, ancillary staff, and motility allied health professionals. When available and within constraints of institutional guidelines, it is preferable for patients scheduled for motility procedures to complete a coronavirus disease 2019 (COVID-19) test within 48 hours before their procedure, similar to the recommendations before endoscopy made by gastroenterology societies. COVID-19 test results must be documented before performing procedures. If procedures are to be performed without a COVID-19 test, full PPE use is recommended, along with all social distancing and infection control measures. Because patients with suspected motility disorders may require multiple procedures, sequential scheduling of procedures should be considered to minimize need for repeat COVID-19 testing. The strategies for and timing of procedure(s) should be adapted, taking into consideration local institutional standards, with the provision for screening without testing in low prevalence areas. If tested positive for COVID-19, subsequent negative testing may be required before scheduling a motility procedure (timing is variable). Specific recommendations for each motility procedure including triaging, indications, PPE use, and alternatives to motility procedures are detailed in the document. These recommendations may evolve as understanding of virus transmission and prevalence of COVID-19 infection in the community changes over the upcoming months.
美国神经胃肠病学和动力学会工作组建议,胃肠动力检查应在符合严格建议和个人防护设备(PPE)措施的动力实验室中进行,以保护患者、辅助人员和动力相关的健康专业人员。在可用且符合机构指南限制的情况下,最好让计划进行动力检查的患者在检查前 48 小时内完成 2019 年冠状病毒病(COVID-19)检测,这与胃肠病学会对内镜检查前的建议相似。COVID-19 检测结果必须在进行检查前记录。如果要在没有 COVID-19 检测的情况下进行检查,则建议使用全套 PPE,并采取所有社交距离和感染控制措施。由于疑似动力障碍的患者可能需要多次检查,应考虑对检查进行连续安排,以尽量减少重复 COVID-19 检测的需要。应根据当地机构标准调整检查策略和时间安排,为低流行地区提供不进行检测的筛查。如果 COVID-19 检测呈阳性,随后可能需要在安排动力检查前再次检测(时间不定)。文件中详细说明了每个动力检查的具体建议,包括分诊、适应证、PPE 使用以及动力检查的替代方法。随着未来几个月对病毒传播和社区 COVID-19 感染流行率的了解不断变化,这些建议可能会发生变化。