Chinese Society of Anesthesiology Expert Consensus on Anesthetic Management of Cardiac Surgical Patients With Suspected or Confirmed Coronavirus Disease 2019

Abstract

The outbreak of a new coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) in China in December 2019 has brought serious challenges to disease prevention and public health. Patients with severe coronavirus disease 2019 (COVID-19) who undergo cardiovascular surgery necessitate extremely high demands from anesthesia personnel, and face high risks of mortality and morbidity. Based on the current understanding of COVID-19 and the clinical characteristics of cardiovascular surgical patients, the authors provide anesthesia management guidelines for cardiovascular surgery along with the prevention and control of COVID-19.

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

“…10 The focus on infection control during airway management in this setting for patients includes limited mask ventilation, full barrier precautions, limited operators, and dedicated airway teams. [11][12] These important considerations apply to all aerosolizing procedures, including bronchoscopy and transesophageal echocardiography, as well as the clinical care of these patients in the interventional suite and operating room environments. [10][11][12][13] The leadership of extracorporeal membrane oxygenation (ECMO) services during this pandemic should design strategies to manage the personnel, equipment, facilities, and support systems for this life-saving therapy.…”

“…[11][12] These important considerations apply to all aerosolizing procedures, including bronchoscopy and transesophageal echocardiography, as well as the clinical care of these patients in the interventional suite and operating room environments. [10][11][12][13] The leadership of extracorporeal membrane oxygenation (ECMO) services during this pandemic should design strategies to manage the personnel, equipment, facilities, and support systems for this life-saving therapy. 3-5; 14-15 Although ECMO has been recommended in COPVID-19 by the World Health Organization, recent guidelines from the Extracorporeal Life Support Organization have highlighted that this modality should be employed in experienced centers as a rescue strategy for severe adult respiratory distress syndrome.…”

Fellowship Training in Adult Cardiothoracic Anesthesiology: Navigating the New Educational Landscape as a Result of the Coronavirus Crisis

“…The severe acute respiratory syndrome coronavirus-2 has spawned a pandemic due to coronavirus disease -19 that is now a worldwide crisis. [1][2][3] The spectrum of COVID-19 includes acute lung injury that may progress to adult respiratory distress syndrome, circulatory shock, renal failure and death. [3][4][5][6] The surge in health care demands for patients with severe COVID-19 across the United States has been overwhelming due to multiple factors, including viral transmission, patient volume, patient acuity, and the requirements for strict infection control.…”

The Renin-Angiotensin-Aldosterone System in Coronavirus Infection—Current Considerations During the Pandemic

“…This perspective will focus on the clinical relevance of these considerations to inform the management of these challenging patients. [8][9][10][11] The references provide further detail for healthcare teams as they manage the demands of the pandemic at their respective institutions. 3 The prevalence of coexisting hypertension has been estimated to be in the (10-25)% range amongst patients presenting with COVID-19.…”