Anesthetic Management of Patients with COVID 19 Infections during Emergency Procedures

J Cardiothorac Vasc Anesth. 2020 May;34(5):1125-1131. doi: 10.1053/j.jvca.2020.02.039. Epub 2020 Feb 28.

Abstract

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.

Keywords: 2019 nCoV; 2019 novel coronavirus; COVID 19; cross-infection; infection control; occupational health; viral pneumonia.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anesthesia* / methods
  • Anesthesia* / standards
  • Betacoronavirus
  • COVID-19
  • Child
  • Child, Preschool
  • China
  • Chronic Disease
  • Comorbidity
  • Coronavirus Infections* / complications
  • Cross Infection* / prevention & control
  • Emergency Medical Services* / standards
  • Female
  • Humans
  • Infection Control* / standards
  • Male
  • Middle Aged
  • Operating Rooms
  • Pandemics*
  • Pneumonia, Viral* / complications
  • Practice Guidelines as Topic
  • Retrospective Studies
  • SARS-CoV-2
  • Young Adult