Background: Since the beginning of COVID-19 pandemic, lack of clinical criteria for intubation in critically ill patients with respiratory failure and simultaneous resource limitations became more noteworthy than before. This study is designed in order to investigate oxygen saturation as an indicator for tracheal intubation in COVID-19 patients.Methods: This is a multi-center, prospective, observational cohort study. We included patients with COVID-19 who needed respiratory support between March to June 2021. Patients were intubated by each institute’s protocol and the anesthesiologist’s clinical judgement. Respiratory symptoms, methods of respiratory support and patients’ outcome were recorded.Results: In this study 117 patients were enrolled. Among 117 studied cases, 100 patients had O2 saturation of 60-90% in whom 58 were intubated. During hospitalization, 56 intubated patients and 14 non-intubated patients died (96.6% Vs. 33.3%).Conclusion: We found that oxygen saturation per se cannot be appropriate criteria for intubating decision.
Spinal muscular atrophy is a rare genetic neuromuscular disease characterized by loss of anterior horn cells of spinal cord and brain stem nuclei, resulting in progressive muscle weakness. Anesthesia for these patients is risky because of the risk of worsening of muscle weakness and consequent postoperative respiratory complications. We report anesthesia management in a nulliparous parturient with type 3 disease who underwent urgent cesarean delivery due to progressive decline of amniotic fluid index.
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