COVID-19 and One-Lung Ventilation

Tryphonopoulos, Peter; McFaul, Colleen; Gagne, Sylvain; Moffett, Stéphane; Byford, Larry; Thompson, Calvin

doi:10.1213/ane.0000000000004915

Cited by 9 publications

(6 citation statements)

References 4 publications

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“…Also, during the COVID-19 pandemic a survey conducted by European Association of Cardiothoracic Anesthesia showed that a bronchial blocker was the preferred technique for lung isolation in patients who were COVID-19 positive, were already intubated and had difficult airways 11 . It is also easy to maintain ‘closed circuit’ with bronchial blocker and can help minimize aerosolization and exposure of perioperative personnel to the virus 12 . Other described techniques to facilitate one lung ventilation in a patient with suspected or confirmed COVID-10 infection includes a laparoscopy smoke evacuation system with a attached filter connected to the tracheal lumen of the double lumen tube to prevent aerosolization of the particles and exposure of healthcare workers 13 .…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Considerations in a Patient With LVAD and COVID-19 Undergoing Video-Assisted Thoracic Surgery

Sikachi

Anca

2021

Journal of Cardiothoracic and Vascular Anesthesia

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Increased survival with Left Ventricular Assist Device (LVAD) has led to a large number of patients with LVADs presenting for non-cardiac surgeries (NCS). With studies showing that a trained non-cardiac anesthesiologist can safely manage these patients when they present for NCS, it is vital that all anesthesiologists understand the LVAD physiology and its implications in various surgeries. This is even more relevant during the current pandemic where these complex cardiopulmonary interactions may be even more challenging in patients with COVID-19. We describe a case of a patient with COVID-19 with an LVAD who needed thoracoscopic decortication for recurrent complex pleural effusion and briefly discuss unique challenges presented and their management.

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Section: Discussionmentioning

confidence: 99%

Anesthetic Considerations in a Patient With LVAD and COVID-19 Undergoing Video-Assisted Thoracic Surgery

Sikachi

Anca

2021

Journal of Cardiothoracic and Vascular Anesthesia

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“…5 However, performing an AGP such as FOB on a COVID-19 patient carries an extremely high risk of transmission to HCW. [6][7][8] Furthermore, the patient was haemodynamically unstable requiring high-dose norepinephrine support and high ventilator settings, thus aggravating his condition if bronchoscopy was done. We were walking on thin ice-to secure the patient's airway, minimise further deterioration and protect the safety of HCW.…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic management in a patient requiring one lung ventilation during COVID-19 pandemic

et al. 2021

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Placement of a double-lumen tube to achieve one lung ventilation is an aerosol-generating procedure. Performing it on a patient with COVID-19 will put healthcare workers at high risk of contracting the disease. We herein report a case of its use in a patient with traumatic diaphragmatic rupture, who was also suspected to have COVID-19. This article aims to highlight the issues, it presented and ways to address them as well as the perioperative impact of personal protective equipment.

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“… Bronchial blockers are recommended as the first choice for patients who arrive in the OR while already intubated patients. If a double-lumen tube is used, the position of the device could be confirmed with a disposable flexible bronchoscope using a swivel with a valve to maintain a better seal during the maneuver and, if possible, putting the ventilator on standby mode with pausing the gas flow to reduce the aerosolizing of contaminated air, while continuing to ventilate the other lumen ( 27 ). An HME filter should be placed on the clamped, not ventilated lumen which is open to the air to facilitate lung collapse ( 26 ).…”

Section: Protection Of the Patientmentioning

confidence: 99%

EACTA/SCA Recommendations for the Cardiac Anesthesia Management of Patients With Suspected or Confirmed COVID-19 Infection: An Expert Consensus From the European Association of Cardiothoracic Anesthesiology and Society of Cardiovascular Anesthesiologists With Endorsement From the Chinese Society of Cardiothoracic and Vascular Anesthesiology

Guarracino

Shernan

Tahan

et al. 2021

Journal of Cardiothoracic and Vascular Anesthesia

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The European Association of Cardiothoracic Anaesthesiology (EACTA) and the Society of Cardiovascular Anesthesia (SCA) aimed to create joint recommendations for the perioperative management of patients with suspected or proven SARS-CoV-2 infection undergoing cardiac surgery or invasive cardiac procedures. To produce appropriate recommendations, we combined the evidence from the literature review, re-evaluating the clinical experience of routine cardiac surgery in similar cases during the Middle East Respiratory Syndrome (MERS-CoV) outbreak and the current pandemic with suspected COVID-19 patients, and the expert opinions through broad discussions within EACTA and SCA. We took into consideration the balance between established procedures and the feasibility during the present outbreak. We represent an agreement between the European and United States practices in managing patients during the COVID-19 pandemic. The recommendations take into consideration a broad spectrum of issues with a focus on preoperative testing, safety concerns, overall approaches to general and specific aspects of preparation for anesthesia, airway management, transesophageal echocardiography, perioperative ventilation, coagulation, and hemodynamic control and postoperative care. As the COVID-19 pandemic is spreading, it will continue to represent a challenge for the worldwide anesthesiology community. To allow these recommendations to be updated as long as possible, we provided weblinks to international public and academic sources providing timely updated data. Our document should be the basis of future Task Forces to develop a more comprehensive consensus considering new evidence uncovered during the COVID-19 pandemic.

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COVID-19 and One-Lung Ventilation

Cited by 9 publications

References 4 publications

Anesthetic Considerations in a Patient With LVAD and COVID-19 Undergoing Video-Assisted Thoracic Surgery

Anesthetic Considerations in a Patient With LVAD and COVID-19 Undergoing Video-Assisted Thoracic Surgery

Anaesthetic management in a patient requiring one lung ventilation during COVID-19 pandemic

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