Assuntos
Anestesiologia/organização & administração , COVID-19/epidemiologia , Pesquisas sobre Atenção à Saúde/estatística & dados numéricos , Pandemias , SARS-CoV-2 , Anestesiologistas/organização & administração , Anestesiologia/estatística & dados numéricos , Conversão de Leitos/estatística & dados numéricos , COVID-19/terapia , Análise Custo-Benefício , Cuidados Críticos/estatística & dados numéricos , Número de Leitos em Hospital/estatística & dados numéricos , Humanos , Unidades de Terapia Intensiva , Admissão e Escalonamento de Pessoal , Espanha/epidemiologiaRESUMO
The current COVID-19 pandemic has rendered up to 15% of patients under mechanical ventilation. Because the subsequent tracheotomy is a frequent procedure, the three societies mostly involved (SEMICYUC, SEDAR and SEORL-CCC) have setup a consensus paper that offers an overview about indications and contraindications of tracheotomy, be it by puncture or open, clarifying its respective advantages and enumerating the ideal conditions under which they should be performed, as well as the necessary steps. Regular and emergency situations are displayed together with the postoperative measures.
Assuntos
Betacoronavirus , Consenso , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Sociedades Médicas , Traqueostomia/normas , Anestesiologia , Broncoscopia/efeitos adversos , Broncoscopia/normas , COVID-19 , Contraindicações de Procedimentos , Unidades de Cuidados Coronarianos , Procedimentos Cirúrgicos Eletivos/normas , Emergências , Humanos , Unidades de Terapia Intensiva , Otolaringologia , Procedimentos Cirúrgicos Otorrinolaringológicos , Pandemias , Cuidados Pós-Operatórios/métodos , Cuidados Pós-Operatórios/normas , Respiração Artificial/normas , Ressuscitação , SARS-CoV-2 , Espanha/epidemiologia , Fatores de Tempo , Traqueostomia/efeitos adversos , Traqueostomia/métodosRESUMO
The current COVID-19 pandemic has rendered up to 15% of patients under mechanical ventilation. Because the subsequent tracheotomy is a frequent procedure, the three societies mostly involved (SEMICYUC, SEDAR and SEORL-CCC) have setup a consensus paper that offers an overview about indications and contraindications of tracheotomy, be it by puncture or open, clarifying its respective advantages and enumerating the ideal conditions under which they should be performed, as well as the necessary steps. Regular and emergency situations are displayed together with the postoperative measures.
Assuntos
Betacoronavirus , Consenso , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Sociedades Médicas , Traqueostomia/normas , Anestesiologia , Broncoscopia/efeitos adversos , Broncoscopia/normas , COVID-19 , Contraindicações de Procedimentos , Unidades de Cuidados Coronarianos , Procedimentos Cirúrgicos Eletivos/normas , Emergências , Humanos , Unidades de Terapia Intensiva , Otolaringologia , Procedimentos Cirúrgicos Otorrinolaringológicos , Pandemias , Cuidados Pós-Operatórios/métodos , Cuidados Pós-Operatórios/normas , Respiração Artificial/normas , Ressuscitação , SARS-CoV-2 , Espanha/epidemiologia , Fatores de Tempo , Traqueostomia/efeitos adversos , Traqueostomia/métodosRESUMO
We have carried out a 9-month retrospective study in the Emergency Resuscitation Unit; 21 patients with abdominal trauma, 42 patients with chest trauma and 895 patients with multiple injuries were treated; 197 (22%) of the latter had also chest and/or abdomen involvement. Of the 260 patients with chest and/or abdomen involvement, six (2.3%) patients had traumatic tear of the diaphragm and four of them, presented thoracic herniation of abdominal content. Diagnostic suspicion was entertained in five patients by means of x-ray plain chest film; diagnosis was confirmed by a barium meal in two patients. In one patient, the diagnosis was established perioperatively. All patients had associated lesions. Four patients required mechanical ventilation after the operation. One patient died of cardiogenic shock on the fourth postoperative day. We emphasize the importance of the suspicion of such condition in patients with multiple injuries with chest and/or abdomen involvement.