Creta Interclinic Hospital, Heraklion, Creta, Greece.
Department MESVA, University of L'Aquila, 67100, L'Aquila, Italy.
Best Pract Res Clin Anaesthesiol. 2020 Sep;34(3):569-582. doi: 10.1016/j.bpa.2020.06.008. Epub 2020 Jul 3.
The COVID-19 outbreak has influenced the entire health care system, including cardiac surgery. In this review, the authors reveal practical aspects that are important during the COVID-19 pandemic with regards to the safe delivery of cardiac anesthesia. Timing for operations of the cardio-vascular system may be well programmed in most cases. Hence, the level of priorities must be defined for any single patient. The postponement of surgery may be convenient for most cases, if it is made in the best interest of the patient. The preanesthetic evaluation should be attentive of the respiratory history of the patient. Cardiac anesthesia always implies some respiratory monitoring; hence the existing clinical situation of the patient's respiratory system should be clear. In case of emergency surgery, the patient should be treated as if they potentially have or are at risk for the virus. In the case of a COVID-19 confirmed or suspected patient, attention must be made to preserve operating room and team integrity. The machineries are to be draped with plastic to simplify the disinfection after the operation. Perioperative management of suspected or confirmed COVID-19 patients must strictly follow the most relevant international guidelines. This review article has synthesized the common aspects present in the most important of these.
COVID-19 疫情已经影响了整个医疗体系，包括心脏手术。在这篇综述中，作者揭示了在 COVID-19 大流行期间，心脏麻醉安全实施方面的一些重要的实际问题。心血管系统手术的时机在大多数情况下都可以很好地规划。因此，必须为每个患者定义优先顺序级别。如果从患者利益最大化的角度来看，推迟手术对大多数情况都是有利的。术前评估应注意患者的呼吸病史。心脏麻醉总是需要进行一些呼吸监测；因此，患者呼吸系统的现有临床情况应该是清楚的。如果是紧急手术，应将患者视为可能患有或有患病毒的风险。对于 COVID-19 确诊或疑似患者，必须注意保持手术室和团队的完整性。应使用塑料覆盖手术器械，以便在手术后进行简化消毒。疑似或确诊 COVID-19 患者的围手术期管理必须严格遵循最相关的国际指南。这篇综述文章综合了这些指南中最重要的部分。
