Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
Best Pract Res Clin Anaesthesiol. 2021 Oct;35(3):321-332. doi: 10.1016/j.bpa.2021.01.002. Epub 2021 Jan 21.
The coronavirus disease 2019 (COVID-19) pandemic has potentiated the need for implementation of strict safety measures in the medical care of surgical patients - and especially in cardiac surgery patients, who are at a higher risk of COVID-19-associated morbidity and mortality. Such measures not only require minimization of patients' exposure to COVID-19 but also careful balancing of the risks of postponing nonemergent surgical procedures and providing appropriate and timely surgical care. We provide an overview of current evidence for preoperative strategies used in cardiac surgery patients, including risk stratification, telemedicine, logistical challenges during inpatient care, appropriate screening capacity, and decision-making on when to safely operate on COVID-19 patients. Further, we focus on perioperative measures such as safe operating room management and address the dilemma over when to perform cardiovascular surgical procedures in patients at risk.
2019 年冠状病毒病（COVID-19）大流行促使人们必须在外科患者的医疗护理中实施严格的安全措施 - 尤其是在心脏手术患者中，他们面临着更高的 COVID-19 相关发病率和死亡率的风险。这些措施不仅需要将患者暴露于 COVID-19 的风险降至最低，还需要仔细平衡推迟非紧急手术程序的风险和提供适当及时的手术护理的风险。我们提供了心脏手术患者中使用的术前策略的最新证据概述，包括风险分层、远程医疗、住院患者护理期间的后勤挑战、适当的筛查能力以及决定何时安全地对 COVID-19 患者进行手术。此外，我们还关注围手术期措施，如安全的手术室管理，并解决在有风险的患者中何时进行心血管手术的困境。
