COVID-19 and ECMO: An Unhappy Marriage of Endothelial Dysfunction and Hemostatic Derangements
Severe respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for coronavirus disease 2019 (COVID-19) that may lead to acute respiratory failure. In its most severe manifestation including refractory hypoxemia and/or hypercapnia, it can require escalation to extracorporeal membrane oxygenation (ECMO). Rates of thromboembolic complications are elevated in COVID-19 patients despite deployment of thromboprophylaxis.1 Amongst the sickest COVID-19 patients requiring ECMO, much less is known regarding hemostatic derangements as well as the resulting risk profile for the development of both thromboembolic as and hemorrhagic complications.
Conclusions: Early results of universal preoperative screening for COVID-19 demonstrates a low incidence and high rate of asymptomatic patients. Health care professionals, especially those at higher risk for the virus, should be aware of the challenges related to screening based solely on symptoms or travel history and consider universal screening for patients undergoing elective surgery. Level of Evidence: Level II.
CONCLUSION: Drilling and microdebrider use during endonasal surgery in a standard operating room is associated with a significant increase in airborne particle concentrations. Fortunately, this increase in aerosol concentration is localized to the area of the operating surgeon, with no detectable increase in aerosol particles at other OR positions. PMID: 33012174 [PubMed - as supplied by publisher]
Digital media&downloads Pain Relief Caused by SARS-CoV-2 Infection May Help Explain COVID-19 Spread New research shows SARS-CoV-2 promotes pain relief when it infects cells through a common protein receptor, neuropilin-1. The finding gives scientists a novel target for non-opioid pain therapeutics, while also offering an explanation for the unrelenting spread of COVID-19. Stacy Pigott Today University of Arizona Health SciencesKhanna_Raj_klh3067.jpg Doctoral student Lisa Boinon prepares buffers while Rajesh Khanna looks on. (Photo: Kris Hanning/University of Arizona Health Sciences)HealthCollege of Medicine - Tuc...
Kirubanand Senniappan, Salome Jeyabalan, Pradeep Rangappa, Muralidhar KanchiIndian Journal of Anaesthesia 2020 64(10):835-841 The coronavirus disease 2019 (COVID-19) is a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Although 85% of infected patients remain asymptomatic, 5% show severe symptoms such as hypoxaemic respiratory failure and multiple end organ dysfunction (MODS) requiring intensive care unit (ICU) admission with a mortality rate of about 2.8%. Since a definitive treatment is yet to be identified, preventive and supportive strategies remain the mainstay of managemen...
This article is protected by copyright. All rights reserved. PMID: 32959455 [PubMed - as supplied by publisher]
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) –related hypercoagulability has been of great interest in the pathophysiology of coronavirus disease 2019 (COVID-19). Many patients have clinical findings of dead-space ventilation, similar to pulmonary embolism. Herein, a patient who presented with COVID-19 pneumonia and whose condition rapidly d eteriorated to respiratory failure requiring intubation is described. Tissue plasminogen activator (tPA) was administered because of concern of pulmonary microemboli, with improvement of respiratory status and extubation within 24 hours.
IN RESPONSE to the coronavirus disease 2019 (COVID-19) pandemic, healthcare facilities deferred all but emergency surgeries for ≥12 weeks to minimize/reduce risk to patients and healthcare workers.1-6 However, by April 2020, increased mortality for delaying necessary cardiac and thoracic procedures prompted multidisciplinary teams to determine how to restart surgical cases safely, balancing the urgent needs of patients, th e reported increased morbidity and mortality of COVID-19–positive patients undergoing surgical procedures,2,3,7,8 and the risk of spreading COVID-19 infection among healthcare workers.
A, Likar R Abstract Coronavirus disease 2019 (COVID-19) progresses mildly in most of the cases; however, about 5% of the patients develop a severe acute respiratory distress syndrome (ARDS). Of all COVID-19 patients 3% need intensive care treatment, which becomes a great challenge for anesthesiology and intensive care medicine, medically, hygienically and for technical safety requirements. For these reasons, only experienced medical and nursing staff in the smallest grouping possible should be assigned. For these team members, a consistent use of personal protective equipment (PPE) is essential.Due...
ConclusionThis study represents the first report of post-operative outcomes in a large group of spine surgical patients in an area heavily affected by the SARS-CoV-2 pandemic.
CORONAVIRUS DISEASE 2019 (COVID-19) is a contagious infection precipitated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2. It is a novel virus of which transmissability, incidence and mortality rates have made it a global emergency. While the clinical manifestations of the virus may vary in severity, it is widely known that the cardiorespiratory system is the principle infection point of the virus, with acute respiratory distress syndrome (ARDS) and shock being possibilities.1