Coronavirus disease (COVID-19) pandemic has led to millions of deaths worldwide. Old age, immunocompromised state and multiple comorbidities are described as risk factors. Kyphoscoliosis (KS) is the most common spine abnormality and a risk factor of respiratory failure. Management of pneumonia in a patient with severe kyphoscoliosis is challenging to the intensivist. We report successful management of two patients with severe kyphoscoliosis who developed severe COVID-19 pneumonia.
A novel severe acute respiratory syndrome coronavirus 2 led to an ongoing coronavirus disease (COVID)-19 pandemic since December 2019. It has affected all age groups; however, older adults are particularly susceptible to the virus and develop severe symptoms, and frequently require critical care admissions. They often require long-term home-based care and multidisciplinary rehabilitation programs. Here, we report a case of complete clinical recovery of a 74-year-old female with no post-COVID sequelae despite severe acute respiratory distress syndrome, multiple comorbidities, and the need for invasive mechanical ventilation. We believe that this case report can further guide the physicians to manage such critical cases.
Background:The bevel position of tracheal tube (TT) affects the success rate while using intubating laryngeal mask airway (ILMA). The present study compared the success of intubation on the basis of anterior and posterior position of the bevel of conventional polyvinylchloride (PVC) tracheal tube through an ILMA. Methods: Two hundred adult ASA I or II patients, having Mallampati class 1 or 2 airway, and undergoing elective surgery under general anesthesia were included in the study. Patients were randomized in two groups based on anterior or posterior bevel position while intubating. If proper tracheal position was established within 3 insertion attempts tracheal intubation was considered successful. Results: Successful tracheal intubation was achieved in 191/200 patients (95.5%). There was higher first attempt success rate in bevel anterior group (88.6% vs 65.5%, relative risk ratio 1.418, 95% C.I. 1.18-16.8; p= 0.00006). There was similar overall success rate between the bevel anterior and posterior groups (97.0% vs 94.0%, relative risk ratio 1.03, 95% C.I. 0.97-1.10; p=0.5). Conclusion: Tracheal intubation was successful in 95.5% of patients through an ILMA using PVC tracheal tube. Success rate of intubation was similar in both the groups. Bevel anterior group had higher success on first attempt intubation.
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