Manejo perioperatorio del paciente con coagulopatía por COVID-19

Abstract

. The appearance of the SARS-CoV-2 coronavirus disease, in China late 2019, has spread rapidly to become a pandemic, the clinical characteristics which range from being asymptomatic to having the severe form, where patients present abnormalities of the Coagulation, generally a hypercoagulable state, may evolve to disseminated intravascular coagulation, multiple organ failure, and / or death. It is important to investigate comorbidities; verify the coagulation status from the first contact, analyzing the routes: endogenous, exogenous, common, fibrinolytic system and platelet count, using technology like thromboelastography and sonoclot. The use of anticoagulants is indicated, it can be used unfractionated or low molecular weight heparin, with laboratory tests to adjust the dose, in order to avoid states of hypocoagulability, use blood products when necessary. Remember that antiviral treatment can have interactions with anticoagulants, especially oral ones, bleeding is not common. There are occlusion problems of installed catheters, one must avoid frequent of these washing with heparin. If the patient requires an emergency surgical or invasive procedure, it must verify the evolution of the coagulation, if it cannot be postponed, use treatment with blood products according to the alteration detected. Follow the management algorithm in the operating room to avoid infections from health personnel.