Anesthetic Management of Patients with COVID 19 Infections during Emergency Procedures
Anesthetic Management of Patients with COVID 19 Infections during Emergency Procedures
复制标题
疑似或确诊2019新型冠状病毒感染患者急诊手术期间的麻醉管理
DOI：
10.1053/j.jvca.2020.02.039
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发表时间：
2020-05-01
影响因子：
2.8
通讯作者：
Chen, Xiangdong
中科院分区：
文献类型：
--
作者：
Zhao, Shuai;Ling, Ken;Chen, Xiangdong
目的：本研究的目的是防止确诊或疑似2019年新型冠状病毒患者在急诊手术期间发生交叉感染（2019-nCoV），并记录这些患者的临床和麻醉相关特征。设计：这是一项回顾性多中心临床研究。设置：本研究使用了来自中国武汉4家医院的多中心数据集。参与者：2020年1月23日至31日，在武汉协和医院、武汉儿童医院、武汉市中心医院、干预措施：起草了疑似2019-nCoV患者急诊手术的麻醉管理和感染控制指南，并在武汉4家医院应用。措施和主要结果：通过实施新措施和程序，有效减少了4家医院手术室的交叉感染。大多数实验室确认的2019-nCoV感染或疑似感染患者为女性（37例中有23例[62%]），平均年龄为41.0岁（标准差19.6;范围4-78）。10例（27%）患者患有慢性内科疾病，其中4例（11%）患有糖尿病，8例（22%）患有高血压，8例（22%）患有消化系统疾病。25例（68%）患者出现淋巴细胞减少，23例（62%）患者在计算机断层扫描上显示多发性斑点和毛玻璃样阴影。结论：本研究表明，针对确诊或疑似2019-nCoV患者的COVID 19特定急诊程序指南可有效预防手术室交叉感染。大多数确诊或疑似COVID 19的患者表现为发热和干咳，胸部计算机断层扫描显示双侧多发性斑点和毛玻璃样阴影。(C)2020爱思唯尔公司All rights reserved.
Objectives: The aim of the present study was to prevent cross-infection in the operating room during emergency procedures for patients with confirmed or suspected 2019 novel coronavirus (2019-nCoV) by following anesthesia management protocols, and to document clinical- and anesthesia-related characteristics of these patients.Design: This was a retrospective, multicenter clinical study.Setting: This study used a multicenter dataset from 4 hospitals in Wuhan, China.Participants: Patients and health care providers with confirmed or suspected 2019-nCoV from January 23 to 31, 2020, at the Wuhan Union Hospital, the Wuhan Children's Hospital, The Central Hospital of Wuhan, and the Wuhan Fourth Hospital in Wuhan, China.Interventions: Anesthetic management and infection control guidelines for emergency procedures for patients with suspected 2019-nCoV were drafted and applied in 4 hospitals in Wuhan.Measurements and Main Results: Cross-infection in the operating rooms of the 4 hospitals was effectively reduced by implementing the new measures and procedures. The majority of patients with laboratory-confirmed 2019-nCoV infection or suspected infection were female (23 [62%] of 37), and the mean age was 41.0 years old (standard deviation 19.6; range 4-78). 10 (27%) patients had chronic medical illnesses, including 4 (11%) with diabetes, 8 (22%) with hypertension, and 8 (22%) with digestive system disease. Twenty-five (68%) patients presented with lymphopenia, and 23 (62%) patients exhibited multiple mottling and ground-glass opacity on computed tomography scanning.Conclusions: The present study indicates that COVID 19-specific guidelines for emergency procedures for patients with confirmed or suspected 2019-nCoV may effectively prevent cross-infection in the operating room. Most patients with confirmed or suspected COVID 19 presented with fever and dry cough and demonstrated bilateral multiple mottling and ground-glass opacity on chest computed tomography scans. (C) 2020 Elsevier Inc. All rights reserved.