Special Article
Thoracic Anesthesia of Patients With Suspected or Confirmed 2019 Novel Coronavirus Infection: Preliminary Recommendations for Airway Management by the European Association of Cardiothoracic Anaesthesiology Thoracic Subspecialty Committee

https://doi.org/10.1053/j.jvca.2020.03.059Get rights and content

Highlights

  • Thoracic anesthesiologists might be involved in the perioperative care of patients suspected to have or diagnosed COVID-19 who might undergo thoracic surgery during the acute or convalescence phases of the disease.

  • Caution should be exercised when securing the airway and performing lung separation (if required), through vigilant donning/doffing of personal protection equipment (PPE), planning ahead, team briefing, proper preparations, systematic approach, and debriefing.

  • Lung separation/isolation should be individualized using either bronchial blockers or double lumen tubes according to the patient's status and perioperative care plan.

  • Optimal PPE donning should be maintained during surgery and anesthesia. One lung ventilation could be challenging in this group of patients.

  • The anesthesiologists should discuss the feasibility of extubating the patient following thoracic surgery, and procedures for postoperative care and transferring the patient to the isolation wards or intensive care unit.

The novel coronavirus has caused a pandemic around the world. Management of patients with suspected or confirmed coronavirus infection who have to undergo thoracic surgery will be a challenge for the anesthesiologists. The thoracic subspecialty committee of European Association of Cardiothoracic Anaesthesiology (EACTA) has conducted a survey of opinion in order to create recommendations for the anesthetic approach to these challenging patients. It should be emphasized that both the management of the infected patient with COVID-19 and the self-protection of the anesthesia team constitute a complicated challenge. The text focuses therefore on both important topics.

Key Words

thoracic anesthesia
lung separation
personal protective equipment
coronavirus
COVID-19

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