RESUMEN
We report 2 cases of bilateral lung transplantation for nonresolving coronavirus disease 2019 associated respiratory failure. In the first patient, the severe acute respiratory syndrome coronavirus 2 infection caused acute respiratory distress syndrome requiring prolonged extracorporeal membrane oxygenation support; in the second patient, coronavirus disease 2019 resulted in irreversible pulmonary fibrosis requiring only ventilatory support. The 2 cases represent the 2 ends of the spectrum showing significant differences in preoperative and postoperative courses.
Asunto(s)
COVID-19 , Trasplante de Pulmón , Síndrome de Dificultad Respiratoria , Insuficiencia Respiratoria , Adulto , Humanos , Masculino , Persona de Mediana Edad , Síndrome de Dificultad Respiratoria/cirugía , Síndrome de Dificultad Respiratoria/virología , Insuficiencia Respiratoria/cirugía , Insuficiencia Respiratoria/virologíaRESUMEN
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.
Asunto(s)
Comités Consultivos/normas , Manejo de la Vía Aérea/normas , Anestesia en Procedimientos Quirúrgicos Cardíacos/normas , Betacoronavirus , Infecciones por Coronavirus/cirugía , Neumonía Viral/cirugía , Guías de Práctica Clínica como Asunto/normas , Manejo de la Vía Aérea/métodos , Anestesia en Procedimientos Quirúrgicos Cardíacos/métodos , Anestesiología/métodos , Anestesiología/normas , COVID-19 , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Europa (Continente)/epidemiología , Humanos , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , SARS-CoV-2RESUMEN
The number of indications for lung collapse during different procedures is rising. Difficult upper airway is more often encountered with the need for single lung ventilation. In patients with difficult airway, the safest approach is by placing a single-lumen endotracheal tube with the aid of a flexible fiberoptic bronchoscope. Lung isolation in these patients is then achieved by means of a bronchial blocker. An alternative technique is exchanging the single-lumen for a double-lumen tube using an airway exchange catheter. When there is a tracheostomy in place, an independent bronchial blocker is recommended.
