COVID-19母亲接受紧急心脏手术所生新生儿的围手术期管理

N. Mageed
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引用次数: 0

摘要

感染COVID-2019的母亲所生的新生儿感染SARS-CoV-2的风险很高,尽管没有记录从母亲到胎儿的直接垂直传播,但婴儿可能在母乳喂养期间通过空气传播或飞沫感染感染。应将婴儿与受感染的母亲以及健康母亲所生的其他新生儿隔离。新生儿出生时有危重和严重的心脏异常通常需要挽救生命的心脏手术干预。术前应稳定患者的血流动力学。即使没有任何COVID-2019的临床、实验室或放射学证据,也应将该患者视为SARS-CoV-2感染传播源。医务人员应使用个人防护装备(PPE),特别是在插管、拔管和处理患者分泌物时。体外循环回路应尽量小,以减少启动容积。本文就不同先天性心脏病的麻醉血流动力学目标及手术室和新生儿重症监护病房医疗团队防范SARS-CoV-2感染传播的方法进行综述。
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Perioperative Management of Neonates Born to Mothers with COVID-19 Undergoing Urgent Cardiac Surgery
Neonates born to mothers with COVID-2019 are at high risk of SARS-CoV-2 infection, although the direct vertical transmission from mother to fetus have not been documented but the baby may be infected during breast feeding by airborne or droplet infection. The baby should be isolated from infected mother and from other neonates born to healthy mothers. Neonates born with critical and severe cardiac anomalies usually require lifesaving cardiac surgical intervention. The patient’s hemodynamics should be stabilized before surgery. The patient should be considered as a source of SARS-CoV-2 transmission of infection even in the absence of any clinical, laboratory or radiologic evidence of COVID-2019. Medical personnel’s should use personal protective equipment (PPE) especially during intubation, extubation and handling patient secretions. The circuits of cardiopulmonary bypass should be small as possible to decrease the priming volume. This review is focused on anesthetic hemodynamic goals of different congenital heart disease and methods of protection of medical team in operating room and neonatal intensive care unit from transmission of SARS-CoV-2 infection.
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