Cardiothoracic and Vascular Anesthesia and Intensive Care, Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
J Cardiothorac Vasc Anesth. 2021 Jul;35(7):1953-1963. doi: 10.1053/j.jvca.2021.02.039. Epub 2021 Feb 17.
The European Association of Cardiothoracic Anaesthesiology (EACTA) and the Society of Cardiovascular Anesthesiologists (SCA) aimed to create joint recommendations for the perioperative management of patients with suspected or proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection undergoing cardiac surgery or invasive cardiac procedures. To produce appropriate recommendations, the authors combined the evidence from the literature review, reevaluating the clinical experience of routine cardiac surgery in similar cases during the Middle East Respiratory Syndrome (MERS-CoV) outbreak and the current pandemic with suspected coronavirus disease 2019 (COVID-19) patients, and the expert opinions through broad discussions within the EACTA and SCA. The authors took into consideration the balance between established procedures and the feasibility during the present outbreak. The authors present an agreement between the European and US practices in managing patients during the COVID-19 pandemic. The recommendations take into consideration a broad spectrum of issues, with a focus on preoperative testing, safety concerns, overall approaches to general and specific aspects of preparation for anesthesia, airway management, transesophageal echocardiography, perioperative ventilation, coagulation, hemodynamic control, and postoperative care. As the COVID-19 pandemic is spreading, it will continue to present a challenge for the worldwide anesthesiology community. To allow these recommendations to be updated as long as possible, the authors provided weblinks to international public and academic sources providing timely updated data. This document should be the basis of future task forces to develop a more comprehensive consensus considering new evidence uncovered during the COVID-19 pandemic.
欧洲心胸麻醉学会（EACTA）和心血管麻醉学会（SCA）旨在为疑似或确诊严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）感染的患者制定联合建议，这些患者正在接受心脏手术或有创性心脏手术。为了制定适当的建议，作者结合了文献综述的证据，重新评估了在中东呼吸综合征（MERS-CoV）爆发期间和当前疑似冠状病毒病 2019（COVID-19）患者的类似病例中常规心脏手术的临床经验，以及通过在 EACTA 和 SCA 内广泛讨论得出的专家意见。作者考虑了在当前疫情期间在既定程序和可行性之间取得平衡。作者提出了在 COVID-19 大流行期间管理患者的欧洲和美国实践之间的协议。该建议考虑了广泛的问题，重点是术前检查、安全问题、总体准备麻醉的一般和具体方面、气道管理、经食管超声心动图、围手术期通气、凝血、血流动力学控制和术后护理。随着 COVID-19 大流行的蔓延，它将继续对全球麻醉学社区构成挑战。为了尽可能更新这些建议，作者提供了指向提供及时更新数据的国际公共和学术来源的网络链接。该文件应作为未来工作组的基础，以制定更全面的共识，考虑在 COVID-19 大流行期间发现的新证据。
