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Review
. 2020 Dec;34(12):3203-3210.
doi: 10.1053/j.jvca.2020.05.042. Epub 2020 Jun 7.

The Cutting Edge of Thoracic Anesthesia During the Coronavirus Disease 2019 (COVID-19) Outbreak

Affiliations
Review

The Cutting Edge of Thoracic Anesthesia During the Coronavirus Disease 2019 (COVID-19) Outbreak

Silvia Fiorelli et al. J Cardiothorac Vasc Anesth. 2020 Dec.

Abstract

Coronavirus disease 2019 (COVID-19) has quickly spread globally, causing a real pandemic. In this critical scenario, lung cancer patients scheduled for surgical treatment need to continue to receive optimal care while protecting them from an eventual severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Adequate use of personal protective equipment (PPE) during aerosol-generating procedures (AGPs) and a COVID-19 specific intraoperative management are paramount in order to prevent cross infections. New suggestions or improvement of existing contagion control guidance are needed, even in case of non-symptomatic patients, possibly responsible for virus spread.

Keywords: 2019-nCoV; COVID-19; airway management; coronavirus; lung cancer; thoracic anesthesia.

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Figures

Fig 1
Fig 1
COVID-19 anamnestic questionnaire and screening algorithm for patients scheduled for lung elective surgery. COVID-19, coronavirus disease 2019; CT, computed tomography; RT-PCR, reverse transcriptase-polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
Fig 2
Fig 2
Sequences for putting on and removing personal protective equipment (PPE).
Fig 3
Fig 3
(A) HEPA filter applied on the inspiratory and expiratory limbs of the breathing circuit. (B) HEPA filter applied between the double catheter mount and the breathing circuit and on the DLT lumen excluded. (C) Protective transparent drape used during a rigid bronchoscopy. DLT, double lumen tube; HEPA, high-efficiency particulate air.
Fig 4
Fig 4
Disposable bronchoscope insertion through the suction port of the swivel connector and a second-generation supraglottic airway device (i-gel).

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