1
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Asensio-Samper JM, Quesada-Carrascosa M, Fabregat-Cid G, López-Alarcón MD, de Andrés J. Practical recommendations for the management of the patient with chronic pain during the pandemic of COVID-19. REVISTA ESPAÑOLA DE ANESTESIOLOGÍA Y REANIMACIÓN 2021; 68:495-503. [PMID: 34732353 PMCID: PMC8531195 DOI: 10.1016/j.redare.2020.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/10/2020] [Indexed: 12/23/2022]
Abstract
SARS-CoV-2 infection has evolved into a pandemic and a Public Health Emergency of International Importance that has forced health organizations at the global, regional and local levels to adopt a series of measures to address to COVID-19 and try to reduce its impact, not only in the social sphere but also in the health sphere, modifying the guidelines for action in the health services. Within these recommendations that include the Pain Treatment Units, patients with suspected or confirmed SARS-CoV-2 infection may be waiting for medical consult or interventional procedures for the management of chronic pain refractory to other therapies. A series of guidelines aimed at reducing the risk of infection of health personnel, other patients and the community are included in this manuscript.
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Affiliation(s)
- J M Asensio-Samper
- Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, Spain; Departamento Cirugía, Facultad de Medicina, Universidad de Valencia, Valencia, Spain.
| | - M Quesada-Carrascosa
- Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - G Fabregat-Cid
- Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - M D López-Alarcón
- Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - J de Andrés
- Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, Spain; Departamento Cirugía, Facultad de Medicina, Universidad de Valencia, Valencia, Spain
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de Arriba-Arnau A, Dalmau Llitjos A, Soria V, Menchón JM, Urretavizcaya M. Effective Adaptation of Ventilation Maneuvers in Electroconvulsive Therapy Sessions During the Coronavirus Disease 2019 Pandemic. J ECT 2021; 37:76. [PMID: 34029303 PMCID: PMC8168704 DOI: 10.1097/yct.0000000000000748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/02/2020] [Indexed: 12/05/2022]
Abstract
Supplemental digital content is available in the text.
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Affiliation(s)
- Aida de Arriba-Arnau
- From the Department of Psychiatry, Bellvitge University Hospital–ICS, Neurosciences Group—Psychiatry and Mental Health, Bellvitge Biomedical Research Institute, Barcelona
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid
| | - Antònia Dalmau Llitjos
- Department of Anesthesiology, Reanimation and Pain Clinic, Bellvitge University Hospital–ICS
| | - Virginia Soria
- From the Department of Psychiatry, Bellvitge University Hospital–ICS, Neurosciences Group—Psychiatry and Mental Health, Bellvitge Biomedical Research Institute, Barcelona
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - José Manuel Menchón
- From the Department of Psychiatry, Bellvitge University Hospital–ICS, Neurosciences Group—Psychiatry and Mental Health, Bellvitge Biomedical Research Institute, Barcelona
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Mikel Urretavizcaya
- From the Department of Psychiatry, Bellvitge University Hospital–ICS, Neurosciences Group—Psychiatry and Mental Health, Bellvitge Biomedical Research Institute, Barcelona
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
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de Arriba-Arnau A, Dalmau Llitjos A, Soria V, Labad J, Menchón JM, Urretavizcaya M. Ventilation Adjustment in ECT During COVID-19: Voluntary Hyperventilation is an Effective Strategy. Neuropsychiatr Dis Treat 2021; 17:1563-1569. [PMID: 34045858 PMCID: PMC8144845 DOI: 10.2147/ndt.s303877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/21/2021] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Airway management is a key objective in adapted electroconvulsive therapy (ECT) protocols during the COVID-19 pandemic to prevent infection. The objective of this study was to describe the effectiveness of a modified ventilation procedure designed to reduce aerosol-generating bag-mask ventilation (BMV) and isolate possible droplets while maintaining adequate respiratory gas values in ECT sessions. MATERIALS AND METHODS This prospective study analyzed the results of the modified protocol applied over a month. Adaptations entailed preoxygenation and extension of the voluntary hyperventilation (VHV) time for two minutes before anesthesia induction, asking patients to hyperventilate with oxygen therapy via nasal cannula and while wearing a face mask. Thereafter, vigorous hyperventilation was avoided, and patients were only assisted with tightly sealed BMV until emergence from anesthesia, isolating the ventilation by using a single-use plastic device. Oxygen saturation (SpO2) and transcutaneous partial pressure of carbon dioxide (TcPCO2) were recorded throughout the session. RESULTS The study included 74 sessions of bilateral ECT with the modified ventilation protocol in 15 subjects. After VHV, the mean SpO2 increase was 2.12±2.14%, and the mean TcPCO2 decrease was 4.05±2.98 mmHg. TcPCO2 values at the moment of stimulus administration were 2.22±3.07 mmHg below pre-ECT values. The mean EEG seizure was 38.70±17.03 s, and postictal suppression was 68.31± 34.58% and 2.13±0.75 on a 0-3 scale. Brief desaturation (SpO2 <90) of 4-5 seconds duration was observed in 4 sessions. CONCLUSION This modified ventilation protocol was effective during COVID-19, and it did not elicit significant side effects. In addition to avoiding vigorous BMV, it induced moderate hypocapnia, which has been tied to seizure optimization and less hypercapnia during the apnea period.
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Affiliation(s)
- Aida de Arriba-Arnau
- Department of Psychiatry, Bellvitge University Hospital-ICS, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. L’Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain
| | - Antònia Dalmau Llitjos
- Department of Anesthesiology, Reanimation and Pain Clinic, Bellvitge University Hospital-ICS, Universitat de Barcelona (UB), Barcelona, Spain
| | - Virginia Soria
- Department of Psychiatry, Bellvitge University Hospital-ICS, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. L’Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona (UB), Barcelona, Spain
| | - Javier Labad
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain
- Department of Mental Health, Consorci Sanitari del Maresme, Mataró, Spain
- Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT), Barcelona, Spain
| | - José Manuel Menchón
- Department of Psychiatry, Bellvitge University Hospital-ICS, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. L’Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona (UB), Barcelona, Spain
| | - Mikel Urretavizcaya
- Department of Psychiatry, Bellvitge University Hospital-ICS, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. L’Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona (UB), Barcelona, Spain
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Johnson H, Garg M, Shantikumar S, Thachil J, Rai B, Aboumarzouk OM, Hashim H, Philip J. COVID-19 (SARS-CoV-2) in Non-Airborne body fluids: A systematic review & Meta-analysis. Turk J Urol 2021; 47:87-97. [PMID: 33819440 PMCID: PMC8018805 DOI: 10.5152/tud.2021.20586] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 01/13/2021] [Indexed: 12/15/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been predominantly respiratory. This study aimed to evaluate the presence of virus in non-airborne body fluids as transmission vehicles. Medline, EMBASE, and Cochrane Library databases were searched from December 01, 2019, to July 01, 2020, using terms relating to SARS-CoV-2 and non-airborne clinical sample sources (feces, urine, blood, serum, serum, and peritoneum). Studies in humans, of any design, were included. Risk of bias assessment was performed using the Quality Assessment of Diagnostic Accuracy 2 tool. Preferred Reporting Items for Systematic Reviews & Meta-Analyses) guidelines were used for abstracting data. If ≥5 studies reported proportions for the same non-respiratory site, a meta-analysis was conducted using either a fixed or random-effects model, depending on the presence of heterogeneity. A total of 22 studies with 648 patients were included. Most were cross-sectional and cohort studies. The SARS-CoV-2 RNA was most frequently detected in feces. Detectable RNA was reported in 17% of the blood samples, 8% of the serum, 16% in the semen, but rarely in urine. Prevalence of SARS-CoV-2 in non-airborne sites varies widely with a third of non-airborne fluids. Patients with bowel and non-specific symptoms have persistence of virus in feces for upto 2 weeks after symptom resolution. Although there was a very low detection rate in urine, given the more frequent prevalence in blood samples, the presence of SARS-CoV-2 in patients with disrupted urothelium or undergoing urinary tract procedures, is likely to be higher. Healthcare providers need to consider non-airborne transmission and persistence of SARS-CoV-2 in body fluids to enable appropriate precautions to protect healthcare workers and carers.
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Affiliation(s)
- Hans Johnson
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Megha Garg
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | | | - Jecko Thachil
- Department of Haematology, Manchester University Hospitals, Manchester, UK
| | - Bhavan Rai
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | | | - Hashim Hashim
- Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
| | - Joe Philip
- Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
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García-Hernández R, Espigares-López M, Miralles-Aguiar F, Gámiz-Sánchez R, Arroyo Fernández F, Pernia Romero A, Torres L, Calderón Seoane E. Immunomodulation using CONVEHY® for COVID-19: from the storm to the cytokine anticyclone. REVISTA ESPAÑOLA DE ANESTESIOLOGÍA Y REANIMACIÓN (ENGLISH EDITION) 2021. [PMCID: PMC7883705 DOI: 10.1016/j.redare.2020.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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6
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[Safe surgery and COVID-19: A narrative review]. J Healthc Qual Res 2021; 36:160-167. [PMID: 33589399 PMCID: PMC7826109 DOI: 10.1016/j.jhqr.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/02/2020] [Accepted: 11/25/2020] [Indexed: 12/15/2022]
Abstract
Fundamentos La interrupción de la actividad asistencial quirúrgica en España provocada por la pandemia debe finalizar. La recuperación de esta actividad ha de realizarse de forma electiva y en convivencia con posibles casos de COVID-19. El objetivo de esta revisión fue la incorporación de criterios de buenas prácticas relacionados con la COVID-19 al contexto de cirugía segura, que permitiesen desarrollar una propuesta de lista de verificación de seguridad quirúrgica adaptada a pacientes con esta enfermedad. Métodos Revisión bibliográfica narrativa, siguiendo el protocolo PRISMA, en los repertorios Medline y Cochrane, utilizando los términos MeSH (coronavirus, infections, safety, surgical procedures, operative, checklist) y el operador booleano AND. Además, se revisaron recomendaciones de organismos y sociedades científicas (literatura gris). Resultados Se incluyeron 33 estudios finales con recomendaciones para la cirugía segura y lista de verificación de seguridad quirúrgica adaptada para COVID-19, siendo los más frecuentes los aspectos relacionados con el tratamiento (41,3%) y medidas de prevención y control (27,6%). Conclusiones La existencia de un amplio consenso en buenas prácticas recomendadas a pacientes COVID quirúrgicos permite realizar una propuesta de lista de verificación de seguridad quirúrgica a estos enfermos.
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7
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Survey on anesthesiology in vascular surgery and COVID-19 pandemic impact. ANGIOLOGIA 2021. [DOI: 10.20960/angiologia.00343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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8
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Perioperative management of patients with suspected or severe infection with SARS-CoV-2 coronavirus programmed for the implementation of electronic devices for the control of chronic pain. REVISTA ESPAÑOLA DE ANESTESIOLOGÍA Y REANIMACIÓN (ENGLISH EDITION) 2020. [PMCID: PMC7833785 DOI: 10.1016/j.redare.2020.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Asensio-Samper JM, Rubio-Haro R, Hernández-Cádiz MJ, De Andrés J. Perioperative management of patients with suspected or severe infection with SARS-CoV-2 coronavirus programmed for the implementation of electronic devices for the control of chronic pain. ACTA ACUST UNITED AC 2020; 67:496-503. [PMID: 32900498 PMCID: PMC7837061 DOI: 10.1016/j.redar.2020.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/16/2020] [Accepted: 06/25/2020] [Indexed: 12/04/2022]
Affiliation(s)
- J M Asensio-Samper
- Anestesiólogo. Médico adjunto. Servicio de Anestesia, Reanimación y Tratamiento del Dolor. Consorcio Hospital General Universitario de Valencia. Profesor Asociado Asistencial Departamento Cirugía. Facultad de Medicina de la Universidad de Valencia, Valencia, España.
| | - R Rubio-Haro
- Médico Interno y Residente 4° año. Servicio de Anestesia, Reanimación y Tratamiento del Dolor. Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - M J Hernández-Cádiz
- Anestesióloga. Médica adjunta. Servicio de Anestesia, Reanimación y Tratamiento del Dolor. Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - J De Andrés
- Anestesiólogo. Catedrático Departamento de Cirugía. Facultad de Medicina de la Universidad de Valencia. Jefe de Servicio de Anestesia, Reanimación y Tratamiento del Dolor. Consorcio Hospital General Universitario de Valencia, Valencia, España
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10
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Asensio-Samper JM, Quesada-Carrascosa M, Fabregat-Cid G, López-Alarcón MD, de Andrés J. Practical recommendations for the management of the patient with chronic pain during the pandemic of COVID-19. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2020; 68:S0034-9356(20)30205-X. [PMID: 33823985 PMCID: PMC7467023 DOI: 10.1016/j.redar.2020.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 12/21/2022]
Abstract
SARS-CoV-2 infection has evolved into a pandemic and a Public Health Emergency of International Importance that has forced health organizations at the global, regional and local levels to adopt a series of measures to address to COVID-19 and try to reduce its impact, not only in the social sphere but also in the health sphere, modifying the guidelines for action in the health services. Within these recommendations that include the Pain Treatment Units, patients with suspected or confirmed SARS-CoV-2 infection may be waiting for medical consult or interventional procedures for the management of chronic pain refractory to other therapies. A series of guidelines aimed at reducing the risk of infection of health personnel, other patients and the community are included in this manuscript.
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Affiliation(s)
- J M Asensio-Samper
- Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, España; Departamento Cirugía, Facultad de Medicina, Universidad de Valencia, Valencia, España.
| | - M Quesada-Carrascosa
- Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - G Fabregat-Cid
- Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - M D López-Alarcón
- Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - J de Andrés
- Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, España; Departamento Cirugía, Facultad de Medicina, Universidad de Valencia, Valencia, España
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11
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García-Hernández R, Espigares-López MI, Miralles-Aguiar F, Gámiz-Sánchez R, Arroyo Fernández FJ, Pernia Romero A, Torres LM, Calderón Seoane E. Immunomodulation using CONVEHY® for COVID-19: from the storm to the cytokine anticyclone. ACTA ACUST UNITED AC 2020; 68:107-112. [PMID: 33455739 PMCID: PMC7456301 DOI: 10.1016/j.redar.2020.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 11/19/2022]
Affiliation(s)
- R García-Hernández
- Especialista en Anestesiología y Reanimación. Coordinador de la Unidad de Reanimación Postquirúrgica. Servicio de Anestesiología y Reanimación. Hospital Universitario Puerta del Mar, España.
| | - M I Espigares-López
- Especialista en Anestesiología y Reanimación. Servicio de Anestesiología y Reanimación. Hospital Universitario Puerta del Mar, España
| | - F Miralles-Aguiar
- Especialista en Anestesiología y Reanimación. Especialista en Medicina Intensiva. Servicio de Anestesiología y Reanimación. Hospital Universitario Puerta del Mar, España
| | - R Gámiz-Sánchez
- Especialista en Anestesiología y Reanimación. Especialista en Medicina Interna. Coordinadora de la Unidad de Reanimación Postquirúrgica. Servicio de Anestesiología y Reanimación. Hospital Universitario Puerta del Mar, España
| | - F J Arroyo Fernández
- Especialista en Anestesiología y Reanimación. Servicio de Anestesiología y Reanimación. Hospital Universitario Puerta del Mar, España
| | - A Pernia Romero
- Especialista en Anestesiología y Reanimación. Jefe de Sección. Servicio de Anestesiología y Reanimación. Hospital Universitario Puerta del Mar, España
| | - L M Torres
- Especialista en Anestesiología y Reanimación. Jefe de servicio. Servicio de Anestesiología y Reanimación. Hospital Universitario Puerta del Mar, España
| | - E Calderón Seoane
- Especialista en Anestesiología y Reanimación. Servicio de Anestesiología y Reanimación. Hospital Universitario Puerta del Mar, España
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12
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Panduro-Correa V, Arteaga-Livias K, Rodríguez-Morales AJ. Coronavirus Disease 2019 (COVID-19) and Surgical Recommendations in Latin America. Am Surg 2020; 86:596-598. [PMID: 32683976 DOI: 10.1177/0003134820927313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Vicky Panduro-Correa
- 33205 Faculty of Medicine, Universidad Nacional Hermilio Valdizán, Huanuco, Peru.,Department of Surgery, Hospital Regional Hermilio Valdizán, Huanuco, Peru
| | - Kovy Arteaga-Livias
- 33205 Faculty of Medicine, Universidad Nacional Hermilio Valdizán, Huanuco, Peru.,Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru
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Urban MJ, Patel TR, Raad R, LoSavio P, Stenson K, Al-Khudari S, Nielsen T, Husain I, Smith R, Revenaugh PC, Wiet RM, Papagiannopoulos P, Batra PS, Tajudeen BA. Implementation of Preoperative Screening Protocols in Otolaryngology During the COVID-19 Pandemic. Otolaryngol Head Neck Surg 2020; 163:265-270. [PMID: 32452746 DOI: 10.1177/0194599820931041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To highlight emerging preoperative screening protocols and document workflow challenges and successes during the early weeks of the COVID-19 pandemic. METHODS This retrospective cohort study was conducted at a large urban tertiary care medical center. Thirty-two patients undergoing operative procedures during the COVID-19 pandemic were placed into 2 preoperative screening protocols. Early in the pandemic a "high-risk case protocol" was utilized to maximize available resources. As information and technology evolved, a "universal point-of-care protocol" was implemented. RESULTS Of 32 patients, 25 were screened prior to surgery. Three (12%) tested positive for COVID-19. In all 3 cases, the procedure was delayed, and patients were admitted for treatment or discharged under home quarantine. During this period, 86% of operative procedures were indicated for treatment of oncologic disease. There was no significant delay in arrival to the operating room for patients undergoing point-of-care screening immediately prior to their procedure (P = .92). DISCUSSION Currently, few studies address preoperative screening for COVID-19. A substantial proportion of individuals in this cohort tested positive, and both protocols identified positive cases. The major strengths of the point-of-care protocol are ease of administration, avoiding subsequent exposures after testing, and relieving strain on "COVID-19 clinics" or other community testing facilities. IMPLICATIONS FOR PRACTICE Preoperative screening is a critical aspect of safe surgical practice in the midst of the widespread pandemic. Rapid implementation of universal point-of-care screening is possible without major workflow adjustments or operative delays.
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Affiliation(s)
- Matthew J Urban
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Tirth R Patel
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Richard Raad
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Phillip LoSavio
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Kerstin Stenson
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Samer Al-Khudari
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Thomas Nielsen
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Inna Husain
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Ryan Smith
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Peter C Revenaugh
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - R Mark Wiet
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Peter Papagiannopoulos
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Pete S Batra
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Bobby A Tajudeen
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
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14
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Medina Garzón M. Abordaje de paciente con sospecha de COVID-19 en el entorno quirúrgico: revisión integrativa. REVISTA CUIDARTE 2020. [DOI: 10.15649/cuidarte.1226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introducción: La necesidad quirúrgica en el contexto de la pandemia actual ocasionada por la enfermedad COVID-19 puede ser de riesgo para los profesionales de la salud. Por esto, se considera que para las enfermedades urgentes que requieren intervención quirúrgica se deben tomar decisiones según las recomendaciones mundiales para el manejo del virus SARS-CoV2. Esta revisión busca describir y analizar las diferentes recomendaciones para el abordaje de un paciente con sospecha de COVID-19 en el entorno quirúrgico. Materiales y métodos: Se realizó una revisión integrativa de literatura con un alcance descriptivo, publicados en el período comprendido entre noviembre de 2019 y abril de 2020, a través de las bases de datos Pubmed, Medline, Science-Direct, Google Scholar y Scopus. Resultados: Se seleccionaron 12 estudios que cumplieron con los criterios de inclusión y que hacen referencia a las medidas y recomendaciones para el abordaje del paciente con sospecha de COVID-19. En el preoperatorio, se enfatiza preparación del quirófano, medidas de protección personal y traslado del paciente al quirófano. En el intraoperatorio, se destacan las medidas para la anestesia, manejo de la vía aérea, limpieza y desinfección del área quirúrgica y recomendaciones específicas para el postoperatorio. Discusión: se discute el equipo de protección personal y las técnicas para minimizar la probabilidad de infección cruzada. Conclusión: El equipo quirúrgico debe mantener las medidas estándar para el manejo del paciente quirúrgico con sospecha de COVID-19 para evitar la propagación y posible contagio por el virus SARS-CoV-2, garantizando una atención quirúrgica segura.
Como citar este artículo: Garzón Medina Mauricio. Abordaje de paciente con sospecha de COVID-19 en el entorno quirúrgico: revisión integrativa. Revista Cuidarte. 2020; 11(2): e1226. http://dx.doi.org/10.15649/cuidarte.1226
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Aguilar G, Tamayo G, Varela M, Maseda E. COVID-19: Es el momento de estar más unidos que nunca. ACTA ACUST UNITED AC 2020; 67:225-226. [PMID: 33994595 PMCID: PMC7255223 DOI: 10.1016/j.redar.2020.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/08/2020] [Indexed: 11/02/2022]
Affiliation(s)
- G Aguilar
- Unidad de Cuidados Críticos, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Valencia
| | - G Tamayo
- Unidad de Reanimación, Servicio de Anestesiología y Reanimación, Hospital Universitario Cruces. Bizkaia
| | - M Varela
- Unidad de Cuidados Críticos. Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario de Pontevedra
| | - E Maseda
- Unidad de Cuidados Críticos Quirúrgicos. Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz. Madrid
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