新常态麻醉师与具有挑战性的COVID-19后毛霉菌病患者——我们的经验

S. Wadhawan, F. Husain, M. Agarwal
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引用次数: 0

摘要

鼻-眶-脑毛霉菌病(ROCM)是一种侵袭性、致命性、血管侵袭性真菌感染,在印度爆发高度传染性和严重的2019年第二次冠状病毒病(新冠肺炎)浪潮的背景下,表现为机会性感染。在第二波疫情中,占主导地位的德尔塔毒株导致新冠肺炎中重度住院人数空前增加。一个有效的分期系统有助于对这些患者进行分类,优先考虑手术清创和两性霉素B脂质体诱导治疗。COVID-19后后遗症的评估和优化成为实现良好围手术期结果的基石。作为麻醉师,我们分享我们在管理这一新型患者方面的经验。COVID-19后的后遗症,包括血栓前状态和多系统受累、挑战性和共用气道,以及两性霉素B相关并发症,是主要关注的问题。
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The New Normal Anesthesiologist and the Challenging Post-COVID-19 Mucormycosis Patients − Our Experience
Rhino-orbital-cerebral mucormycosis (ROCM) is an aggressive, lethal, angioinvasive fungal infection that has presented as an opportunistic infection in the backdrop of a highly infectious and severe second coronavirus disease 2019 (COVID-19) wave in India. The dominant delta strain during the second wave led to an unprecedented rise in hospital admissions with moderate to severe COVID-19 illness. A working staging system is helpful in triaging these patients to prioritize surgical debridement and liposomal amphotericin B induction therapy. The evaluation and optimization of post-COVID-19 sequelae becomes a cornerstone in achieving a favorable perioperative outcome. As anesthesiologists, we share our experience in managing this novel subset of patients. Post-COVID-19 sequelae with a prothrombotic state and multisystem involvement, challenging and shared airway, and amphotericin B-related complications are being the key concerns.
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