2020, Number 4
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Rev Mex Anest 2020; 43 (4)
Recommendations and actions for the anesthetic management of pediatric cardiac surgery during the SARS-CoV-2 pandemic
Pellecer-González LC, Tamariz-Cruz O
Language: Spanish
References: 25
Page: 230-240
PDF size: 371.87 Kb.
ABSTRACT
The pandemic produced by the new SARS-CoV-2 coronavirus has indelibly marked the history of humanity. The conducts, actions and habits of people have changed substantially, redefining our activities at all levels. Our specialty is dedicated to the care of pediatric patients with congenital heart defects, from the neonatal stage to adolescence. In this age group, the symptomatic picture of COVID-19 is not present in most cases, therefore, anesthetic practice is carried out with precautions aimed to assist asymptomatic patients considered not carriers of the virus SARS-CoV-2, without the complete elements of personal protective equipment. This document compiles the practices and guidelines adopted by the anesthetists of the KARDIAS program for the care of children with congenital heart defects during the COVID-19 pandemic. We have made an adaptation of the different guidelines reported on anesthetic, pediatric, cardiovascular and echocardiographic management, adhering to the evidence reported to date. These recommendations are applicable for any center that performs pediatric cardiovascular anesthesia with modifications according to its institutional requirements and they should be periodically reviewed regarding new scientific evidence reported. Finally, we comment about the appearance of a probable new clinical presentation of SARS-CoV-2 infection as an atypical variety of Kawasaki disease in children.
REFERENCES
Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N Engl J Med. 2020;382:970-971.
Bai Y, Yao L, Wei T, et al. Presumed asymptomatic carrier transmission of COVID-19. JAMA. 2020;323:1406-1407.
Li R, Pei S, Chen B, et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science. 2020;368:489-493.
Hoehl S, Rabenau H, Berger A, et al. Evidence of SARS-CoV-2 infection in returning travelers from Wuhan, China. N Engl J Med. 2020;382:1278-1280.
Ng OT, Marimuthu K, Chia PY, et al. SARS-CoV-2 infection among travelers returning from Wuhan, China. N Engl J Med. 2020;382:1476-1478. doi: 10.1056/NEJMc2003100.
Main COVID-19: https://www.cdc.gov/coronavirus/2019-nCoV/index.html / Individuals at high risk: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk- complications.html.
Children and COVID-19. Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/faq.html#anchor_1584387482747.
Pregnancy and COVID-19. Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/prepare/pregnancy- breastfeeding.html
Guidance from the White House, the U.S. Department of Health and Human Services (HHS), and CDC. Disponible en: https://www.coronavirus.gov/
World Health Organization COVID-19 site. Disponible en: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
AAP Healthy Children COVID-19 site. Disponible en: https://www.healthychildren.org/English/health-issues/conditions/chest- lungs/Pages/2019-Novel-Coronavirus.aspx
Adult Congenital Heart Association webinar on March 16, 2020 on Coronavirus and the CHD patient. Disponible en: https://youtu.be/hou2qM1phVQ
Sisters By Heart Facebook Live event from March 17, 2020 on Coronavirus and Children with CHD. Disponible en: https://www.facebook.com/156971814350396/videos/2817193955063709/
COVID-19 information from Conquering CHD. Disponible en: https://www.conqueringchd.org/covid-19-update/
ASE Statement on Protection of Patients and Echocardiography Service Providers During the 2019 Novel Coronavirus Outbreak. ASEcho.org
Xiaoxia L, Zhang L, Du H. SARS-CoV-2 infection in children. NEJM. 2020. doi: 10.1056/NEJMc2005073.
Zhao S, Ling K, Yan H, Zhong L, Peng X, Yao S, et al. Anesthetic Management of patients with suspected or confirmed 2019 Novel coronavirus infection during emergency procedures. J Cardiovasc Vasc Anesth. 2020. Disponible en: https://doi.org/10.1053/j.jvca.2020.02.039
Zucco L, Levy N, Ketchandji D, Aziz M, Ramachandran SK. Recommendations for airway management in patient with suspected coronavirus (2019-nCoV) Infection. www.apsf.org
Zimmermann P, Curtis N. Coronavirus infections in children including COVID-19. An overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children. Pediatr Infect Dis J. 2020. doi: 10.1097/INF.0000000000002660.
American College of Surgeons. COVID-19: Considerations for optimum surgical protection before, during and after operation. www.facs.org
Esper F, Shapiro ED, Weibel C, Ferguson D, Landry ML, Kahan JS. Association between a novel human coronavirus and Kawasaki disease. JID. 2005;191:499.502.
North Central London CCG’s Incident Coordination Centre. North Central London Clinical Commissioning Group. Significant alert in respect of Children and Pediatric shock for urgent action. 2020.
Rowley AH, Shulman ST. The epidemiology and pathogenesis of Kawasaki disease. Front Pediatr. 2018;6:374. doi: 10.3389/fped.2018.00374.
Riphagen S, Gomez X, González-Martínez C. Hiperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020. Disponible en: doi.org/10.1016/S0140-6736(20)31094-1
Pellecer L y Tamariz-Cruz O. Definiciones operativas y protocolo anestésico durante la pandemia producida por SARS-CoV-2 en un programa de cirugía cardíaca pediátrica. Revista Chilena de Anestesia 2020; 49: 372-387 |https://doi.org/10.25237/revchilanestv49n03.016