Posicionamento para Ressuscitação Cardiopulmonar de Pacientes com Diagnóstico ou Suspeita de COVID-19 – 2020

Guimarães, Hélio Penna; Timerman, Sérgio; Rodrigues, Roseny dos Reis; Corrêa, Thiago Domingos; Schubert, Daniel Ujakow Correa; Freitas, Ana Paula; Réa-Neto, Álvaro; Polastri, Thatiane Facholi; Vane, Matheus Fachini; Couto, Thomaz Bittencourt; Brandão, Antônio Carlos Aguiar; Giannetti, Natali Schiavo; Timerman, Thiago; Hajjar, Ludhmila Abrahão; Bacal, Fernando; Lopes, Marcelo Antônio Cartaxo Queiroga

doi:10.36660/abc.20200548

Cited by 17 publications

(18 citation statements)

References 17 publications

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“…A recent joint position statement from Brazilian societies of cardiology, intensive care medicine, anesthesiology and emergency medicine recommends to turn into supine position the patients once safely possible, due to insufficient evidences on reverse CPR and suggests monitoring using partial pressure of end-tidal carbon dioxide partial (EtCO 2 > 10 mmHg) and diastolic pressure (>20 mmHg) [44].…”

Section: Practical Aspects and Guidelines Recommendationsmentioning

confidence: 99%

“…An early planning of supination is recommended, since it may require additional help [30,44]. For the specific setting of neurosurgery, UK Resuscitation Council suggests that there is no immediate need to turn the patient to the supine position once cardiac arrest has occurred in the prone position, suggesting to start CPR in the prone position [45].…”

Section: Practical Aspects and Guidelines Recommendationsmentioning

confidence: 99%

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Cardiopulmonary resuscitation in prone position: A scoping review

Moscarelli

Iozzo

Ippolito

et al. 2020

The American Journal of Emergency Medicine

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Introduction: The ongoing pandemic of COVID-19 brought to the fore prone positioning as treatment for patients with acute respiratory failure. With the increasing number of patients in prone position, both spontaneously breathing and mechanically ventilated, cardiac arrest in this position is more likely to occur. This scoping review aimed to summarize the available evidence on cardiopulmonary resuscitation in prone position ('reverse CPR') and knowledge or research gaps to be further evaluated. The protocol of this scoping review was prospectively registered on 10th May 2020 in Open Science Framework (https://osf.io/nfuh9). Methods: We searched PubMed, EMBASE, MEDLINE and pre-print repositories (bioRxiv and medRxiv) for simulation, pre-clinical and clinical studies on reverse CPR until 31st May 2020. Results: We included 1 study on manikins, 31 case reports (29 during surgery requiring prone position) and 2 nonrandomized studies describing reverse CPR. No studies were found regarding reverse CPR in patients with COVID-19. Conclusions: Even if the algorithms provided by the guidelines on basic and advanced life support remain valid in cardiac arrest in prone position, differences exist in the methods of performing CPR. There is no clear evidence of superiority in terms of effectiveness of reverse compared to supine CPR in patients with cardiac arrest occurring in prone position. The quality of evidence is low and knowledge gaps (e.g. protocols, training of healthcare personnel, devices for skill acquisition) should be fulfilled by further research. Meanwhile, a case-by-case evaluation of patient and setting characteristics should guide the decision on how to start CPR in such cases.

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Section: Practical Aspects and Guidelines Recommendationsmentioning

confidence: 99%

Section: Practical Aspects and Guidelines Recommendationsmentioning

confidence: 99%

Cardiopulmonary resuscitation in prone position: A scoping review

Moscarelli

Iozzo

Ippolito

et al. 2020

The American Journal of Emergency Medicine

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“…Thus, coordination with the anesthesia team is essential during both intubation and extubation. In these two moments, it is recommended that all personnel not essential to the procedure leave the room and only return after the airways are protected (31,37,47).…”

Section: Protection During Head and Neck Surgerymentioning

confidence: 99%

Recommendations for head and neck surgical procedures during the COVID-19 pandemic

Kulcsar

Montenegro

Santos

et al. 2020

Clinics

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The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread exponentially worldwide. In Brazil, the number of infected people diagnosed has been increasing and, as in other countries, it has been associated with a high risk of contamination in healthcare teams. For healthcare professionals, the full use of personal protective equipment (PPE) is mandatory, such as wearing surgical or filtering facepiece class 2 (FFP2) masks, waterproof aprons, gloves, and goggles, in addition to training in care processes. A reduction in the number of face-to-face visits and non-essential elective procedures is also recommended. However, surgery should not be postponed in the case of the most essential elective indications (mostly associated with head and neck cancers). As malignant tumors of the head and neck are clinically time sensitive, neither consultations for these tumors nor their treatment should be postponed. Postponing surgical treatment can result in a change in the disease stage and alter an individual's chance of survival. In this situation, planning of all treatments must begin with the request for, in addition to routine examinations, a nasal swab polymerase chain reaction for SARS-CoV-2 and chest computed tomography. Only if the results of these tests are positive or if fever or other symptoms suggestive of COVID-19 are present should the surgical procedure be postponed until the patient completely recovers. This is mandatory not only because of the risk of contamination of the surgical team but also because of the increased risk of postoperative complications and high risk of death. During this pandemic, the most effective safety measures are social distancing for the general public and the adequate availability and use of PPE in the healthcare field. The treatment of other chronic diseases, such as cancer, should be continued, as the damming of cases of these diseases will have a deleterious effect on the public healthcare system.

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“…Intubation, aspiration and active cardiopulmonary resuscitation can generate aerosol particles from respiratory secretions, increasing the likelihood of personal exposure. 54 Patients already intubated pose a lower contamination risk to healthcare personnel, because they are on closed-loop ventilation. 55 For patients with suspected or confirmed COVID-19 who need orotracheal intubation, this intervention should be performed before arrival to the CCL.…”

Section: Patients Requiring Intubation Aspiration or Cardiopulmonarymentioning

confidence: 99%

Imagem Cardiovascular e Procedimentos Intervencionistas em Pacientes com Infecção pelo Novo Coronavírus

Costa¹,

Rochitte²,

Campos³

et al. 2020

Arquivos Brasileiros De Cardiologia

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The coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures. This review was aimed at: a) helping physicians to properly indicate and implement cardiovascular tests and interventional procedures in their clinical practice for patients with suspected

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Posicionamento para Ressuscitação Cardiopulmonar de Pacientes com Diagnóstico ou Suspeita de COVID-19 – 2020

Cited by 17 publications

References 17 publications

Cardiopulmonary resuscitation in prone position: A scoping review

Cardiopulmonary resuscitation in prone position: A scoping review

Recommendations for head and neck surgical procedures during the COVID-19 pandemic

Imagem Cardiovascular e Procedimentos Intervencionistas em Pacientes com Infecção pelo Novo Coronavírus

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