Comentarios desactivados en Manejo Perioperatorio del Paciente con Sospecha o Confirmación de Infección por COVID-19

Manejo Perioperatorio del Paciente con Sospecha o Confirmación de Infección por COVID-19

Publicado por en Cirugía General
Autores: María del Carmen Rentería-Arellano, Juan Roberto Torres-Cisneros, Hugo de Jesús Ballesteros Loyo

El SARS-CoV-2 afecta al huésped utilizando el receptor de la enzima convertidora de la angiotensina 2 (ACE2).

El primer paso en la entrada del virus es la unión de la proteína trimérica S (spike) del virus al receptor ACE2 humano, el cual se expresa en múltiples órganos, incluyendo el pulmón, corazón, riñón e intestino, y aún más importante en el tejido endotelial.

Dentro de la fisiopatología principal está la tormenta de citoquinas, es la respuesta inflamatoria sistémica no controlada que resulta de la liberación de grandes cantidades de citoquinas proinflamatorias y quimioquinas por células inmunoefectoras.

La tormenta de citoquinas se une a la respuesta metabólica al trauma de una cirugía, lo cual ocasiona una hiperrespuesta inflamatoria que puede llegar a la falla orgánica múltiple.

El manejo del paciente con la enfermedad de COVID-19 y cirugía implica diferentes especialidades médicas y quirúrgicas.

Consulta el artículo completo en la revista Cirujano General

Referencias

  1. Sociedad Española de Inmunología. Información sobre COVID-19. Versión cov01. Abril 2020.
  2. Guo YR, Cao QD, Hong ZS, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status. Mil Med Res. 2020; 7: 11. doi: 10.1186/s40779-020-00240-0
  3. van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020; 382:1564-1567. doi: 10.1056/NEJMc2004973.
  4. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395: 497-506. doi: 10.1016/S0140-6736(20)30183-5.
  5. Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol. 2017; 39: 529-539. doi: 10.1007/s00281-017-0629-x.
  6. Karakike E, Giamarellos-Bourboulis EJ. Macrophage activation-like syndrome: a distinct entity leading to early death in sepsis. Front Immunol. 2019; 10: 55. doi: 10.3389/fimmu.2019.00055.
  7. Kan FK, Tan CC, Von Bahr Greenwood T, et al. Dengue infection complicated by hemophagocytic lymphohistiocytosis: experiences from 180 patients with severe dengue. Clin Infect Dis. 2020; 70: 2247-2255. doi: 10.1093/cid/ciz499.
  8. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020; 395: 1033-1034. doi: 10.1016/S0140-6736(20)30628-0.
  9. Varga Z, Flammer AJ, Steiger P, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020; 395: 1417-1418. doi: 10.1016/S0140-6736(20)30937-5.
  10. Ferrario CM, Jessup J, Chappell MC, et al. Effect of angiotensin-converting enzyme inhibition and angiotensin II receptor blockers on cardiac angiotensin-converting enzyme 2. Circulation. 2005; 111: 2605-2610.
  11. Flammer AJ, Anderson T, Celermajer DS, et al. The assessment of endothelial function: from research into clinical practice. Circulation. 2012; 126: 753-767. doi: 10.1161/CIRCULATIONAHA.112.093245.
  12. Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020; 130: 2620-2629.
  13. Anderson TJ, Meredith IT, Yeung AC, et al. The effect of colesterol lowering and antioxidant therapy on endothelium-dependent coronary vasomotion. N Engl J Med. 1995; 332: 488-493.
  14. Feldmann M, Maini RN, Woody JN, et al. Trials of anti-tumour necrosis factor therapy for COVID-19 are urgently needed. Lancet. 2020; 395: 1407-1409. doi: 10.1016/S0140-6736(20)30858-8.
  15. Garduño‑López AL, Guido‑Guerra RE, Guizar‑Rangel MT, et al. Manejo perioperatorio del paciente con COVID-19. Rev Mex Anest. 2020; 43: 109-120.
  16. COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020; 396: 27-38. doi: 10.1016/S0140-6736(20)31182-X.
  17. Myles PS, Maswime S. Mitigating the risks of surgery during the COVID-19 pandemic. Lancet. 2020; 396: 2-3. doi: 10.1016/S0140-6736(20)31256-3.
  18. Peng PWH, Ho PL, Hota SS. Outbreak of a new coronavirus: what anaesthetists should know. Br J Anaesth. 2020; 124: 497-501. doi: 10.1016/j.bja.2020.02.008.
  19. Aminian A, Safari S, Razeghian-Jahromi A, Ghorbani M, Delaney CP. COVID-19 outbreak and surgical practice: unexpected fatality in perioperative period. Ann Surg. 2020; 272: e27-e29. doi: 10.1097/SLA.0000000000003925.
  20. Brindle M, Gawande A. Managing COVID-19 in surgical systems. Ann Surg. 2020; 272: e1-e2. doi: 10.1097/SLA.0000000000003923.
  21. Zheng MH, Boni L, Fingerhut A. Minimally invasive surgery and the novel coronavirus outbreak: lessons learned in China and Italy. Ann Surg. 2020; 272: e5-e6. doi: 10.1097/SLA.0000000000003924.
  22. American College of Surgeons. COVID-19: elective case triage guidelines for surgical care. 2020.
  23. Ti LK, Ang LS, Foong TW, Ng BSW. What we do when a COVID-19 patient needs an operation: operating room preparation and guidance. Can J Anaesth. 2020; 67: 756-758. doi: 10.1007/s12630-020-01617-4.
  24. Wong J, Goh QY, Tan Z, et al. Preparing for a COVID-19 pandemic: a review of operating room outbreak response measures in a large tertiary hospital in Singapore. Can J Anaesth. 2020; 67: 732-745.
  25. Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill. 2020; 25: 2000180.
  26. American College of Surgeons. COVID-19: considerations for optimum surgeon protection before, during, and after operation. Marzo 27, 2020.
  27. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395: 1054-1062.
  28. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020; 323: 1061-1069.
  29. Guía para el Cuidado Crítico de Pacientes Adultos Graves con Coronavirus (COVID-19) en Las Américas. Organización Panamericana de la Salud (OPS), Organización Mundial de la Salud (OMS). Abril 3, 2020.
  30. Xu X, Ong YK, Wang Y. Role of adjunctive treatment strategies in COVID-19 and a review of international and national clinical guidelines. Mil Med Res. 2020; 7: 22. doi: 10.1186/s40779-020-00251-x.
  31. Phua J, Weng L, Ling L, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med. 2020; 8: 506-517. doi: 10.1016/S2213-2600(20)30161-2.
  32. COVID-19 Treatment Guidance Writing Group. JHMI Clinical Guidance for Available Pharmacologic Therapies 2020, 25 March 2020. Available in: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540747/all/Coronavirus_COVID_19__SARS_CoV_2_.
  33. Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the treatment of Covid-19-preliminary report. N Engl J Med. 2020; NEJMoa2007764.

Calzada General Anaya No. 330, Col. Del Carmen, Coyoacán. CP.: 04100, CDMX

Llámanos

Llámanos

(55) 5658 2431 | (55) 5658 2263

Envíanos un correo

Envíanos un correo

[email protected]