Critical Care During the Coronavirus Crisis: Challenges and Considerations for the Cardiothoracic and Vascular Anesthesia Community

Hematologic Consequences of the Coronavirus Crisis—Focus on Relevant Clues and Complications for the Perioperative Cardiothoracic and Vascular Community

“…22 A third mechanism for lymphopenia may be decreased proliferation from significant acidosis associated with severe COVID-19. [3][4][5]23 Beyond lymphopenia, recent evidence from multiple clinical trials has suggested that thrombocytopenia is not only common but is very often associated with severe COVID-19. 24 Although the severity of the thrombocytopenia may at times correlate with the clinical severity of coronavirus infection, there may also be a platelet spike in the setting of a pronounced cytokine storm.…”

Cardiopulmonary Resuscitation During the Coronavirus Crisis: Important Updates for the Cardiothoracic and Vascular Anesthesia Community

“…The spectrum of infection with COVID-19 includes risks of hospital admission and critical illness that have been estimated to be in the 10% to 20% and 5% to 10% ranges, respectively. 8,9 The possible etiologies for cardiac arrest in COVID-19 include hypoxia from acute respiratory distress syndrome, cardiogenic shock from myopericarditis, and vasoplegic shock from associated sepsis. 8,9 Furthermore, severe infection in COVID-19 can precipitate acute coronary syndromes and significant arrhythmias in patients with predisposing risk factors.…”

“…8,9 The possible etiologies for cardiac arrest in COVID-19 include hypoxia from acute respiratory distress syndrome, cardiogenic shock from myopericarditis, and vasoplegic shock from associated sepsis. 8,9 Furthermore, severe infection in COVID-19 can precipitate acute coronary syndromes and significant arrhythmias in patients with predisposing risk factors. 8,9 The risk of arrhythmias also may be increased by proposed therapies for COVID-19 such as hydroxychloroquine and azithromycin through their prolongation of the QT interval.…”

“…8,9 Furthermore, severe infection in COVID-19 can precipitate acute coronary syndromes and significant arrhythmias in patients with predisposing risk factors. 8,9 The risk of arrhythmias also may be increased by proposed therapies for COVID-19 such as hydroxychloroquine and azithromycin through their prolongation of the QT interval. 9,10 Given that there are multiple mechanisms for cardiac arrest in COVID-19, it is likely that there may be more than 1 mechanism in certain patients.…”

Tips for pandemic response planning for Internal Medicine training programs

“…With the potential for a steep influx of ill patients, it is critical to be able to expand inpatient service lines with a particular focus on critical care units to meet evolving health system demands. In a prevailing pandemic care model, as the patient surge intensifies, additional providers with appropriate training should be deployed in a tiered fashion to increase service line capacity (Augoustides, 2020). Residency programs may consider removing residents from non-essential rotations such as consult services and clinic electives to expand their available healthy provider pool.…”