Intubation Call for Coronavirus Disease 2019 (COVID-19) Patients
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Published:
Jul 31, 2020
Keywords:
Anesthesiologist, COVID-19, Intubation
Main Article Content
Abstract
During COVID-19 pandemic, the anesthesiologists
have responsibility for intubation in COVID-19 patients
who develop hypoxia and require ventilatory support.
Intubation is a critical time of viral spreading. We would
like to share and compare our intubation experiences with
COVID-19 patients in the context of existing guidelines
and recommendations. There were four COVID-19
patients involved by anesthesiologists at Siriraj Hospital.
Three patients required intubation while one patient
required endotracheal tube changing. There were both
similar and different in intubation processes with existing
guidelines and recommendations. However, several topics
are still controversies. Reliable use of personnel protective
equipment significantly prevents contact disease. All
involved staff were healthy afterward. The excellent
communication sharing updated information for clinicians
is necessary in every hospital. Finally, the local guidelines
also need to be regularly updated and revised following
the updated knowledge that rapidly changes.
Article Details
Section
Case reports
References
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and the Chinese Association of Anesthesiologists.
Anesthesiology 2020;132:1307-16.
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aerosol box in protecting healthcare workers during the
Covid-19 pandemic. Anaesthesia 2020. doi: 10.1111/anae.
15109.
27. Hui DS, Chow BK, Lo T, et al. Exhaled air dispersion during
high-flow nasal-cannula therapy versus CPAP via different
masks. Eur Respir J 2019;53(4) doi: 10.1183/13993003.02339-
2018
28. Kotoda M, Hishiyama S, Mitsui K, et al. Assessment of the
potential for pathogen dispersal during high-flow nasal
therapy. J Hosp Infect 2020;104:534-7.
29. Simonnet A, Chetboun M, Poissy J, et al. High prevalence
of obesity in severe acute respiratory syndrome Coronavirus-2
(SARS-CoV-2) requiring invasive mechanical ventilation.
Obesity (Silver Spring) 2020. doi: 10.1002/oby.22831.
30. Brewster DJ, Chrimes N, Do TB, et al. Consensus statement:
Safe-Airway Society principles of airway management and
tracheal intubation specific to the COVID-19 adult patient
group. Med J Aust 2020. doi: 10.5694/mja2.50598.
31. Suzuki K, Kusunoki S, Tanigawa K, Shime N. Comparison of
three video laryngoscopes and direct laryngoscopy for
emergency endotracheal intubation: A retrospective cohort
study. BMJ Open 2019;9(3):e024927. doi: 10.1136/bmjopen-
2018-024927.
32. Cook F, Lobo D, Martin M, et al. Prospective validation of a
new airway management algorithm and predictive features
of intubation difficulty. Br J Anaesth 2019;122:245-54.
Barrier enclosure during endotracheal intubation. N Engl J
Med 2020;14;382:1957-58.
2. 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;382:1564-7.
3. Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J.
Aerosol-generating procedures and risk of transmission of
acute respiratory infections to healthcare workers: A
systematic review. PLoS One 2012;7:e35797. doi: 10.1371/
journal.pone.0035797.
4. Luo M, Cao S, Wei L, et al. Precautions for intubating patients
with COVID-19. Anesthesiology 2020;132:1616-1618.
5. Runnels S, Ferranti D, Davis AN, Pollard J. The Utah model:
Mental bandwidth and strategic risk generation in COVID-19
airway management. Anaesthesia 2020. doi: 10.1111/anae.
15086.
6. Abrahamson SD, Canzian S, Brunet F. Using simulation for
training and to change protocol during the outbreak of severe
acute respiratory syndrome. Crit Care 2006;10:R3. doi:
10.1186/cc3916.
7. Fregene TE, Nadarajah P, Buckley JF, Bigham S, Nangalia
V. Use of in situ simulation to evaluate the operational
readiness of a high-consequence infectious disease
intensive care unit. Anaesthesia 2020;75:733-8.
8. Matava CT, Kovatsis PG, Summers JL, et al. Pediatric Airway
management in COVID-19 patients - consensus guidelines
from the Society for Pediatric Anesthesia’s Pediatric Difficult
Intubation Collaborative and the Canadian Pediatric
Anesthesia Society. Anesth Analg 2020. doi: 10.1213/ANE.
0000000000004872.
9. Cook TM, El-Boghdadly K, McGuire B, McNarry AF, Patel A,
Higgs A. Consensus guidelines for managing the airway in
patients with COVID-19: Guidelines from the difficult-airway
society, the Association of Anaesthetists, the Intensive Care
Society, the Faculty of Intensive Care Medicine, and the
Royal College of Anaesthetists. Anaesthesia 2020;75:785-99.
10. Wax RS, Christian MD. Practical recommendations for critical
care and anesthesiology teams caring for novel coronavirus
patients (2019-nCoV) patients. Can J Anaesth 2020;67:568-76.
11. Sorbello M, El-Boghdadly K, Di Giacinto I, et al. The italian
coronavirus disease 2019 outbreak: recommendations from
clinical practice. Anaesthesia 2020;75:724-32.
12. Peng PWH, Ho PL, Hota SS. Outbreak of a new coronavirus:
what anaesthetists should know. Br J Anaesth 2020;124:
497-501.
13. Zhang HF, Bo L, Lin Y, et al. Response of Chinese anesthesiologists
to the COVID-19 outbreak. Anesthesiology
2020;132:1333-38.
14. Wang J, Zhou M, Liu F. Reasons for healthcare workers
becoming infected with the novel coronavirus disease 2019
(COVID-19) in China. J Hosp Infect 2020;105:100-101.
15. Wu Z, McGoogan JM. Characteristics of and important
lessons from the Coronavirus disease 2019 (COVID-19)
outbreak in China: summary of a report of 72,314 cases from
the Chinese Center for Disease Control and Prevention.
JAMA 2020. doi: 10.1001/jama.2020.2648.
16. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of the
coronavirus disease 2019 in China. N Engl J Med 2020;382:
1708-20.
17. Yao W, Wang T, Jiang B, et al. Emergency tracheal intubation
in 202 patients with COVID-19 in Wuhan, China: Lessons
learned and international expert recommendations. Br J
Anaesth 2020. doi: 10.1016/j.bja.2020.03.026.
18. Christian MD, Loutfy M, McDonald LC, et al. Possible SARS
coronavirus transmission during cardiopulmonary resuscitation.
Emerg Infect Dis 2004;10:287-93.
19. Meng L, Qiu H, Wan L, et al. Intubation and ventilation amid
the COVID-19 outbreak: Wuhan’s experience. Anesthesiology
2020;132:1317-32.
20. Zuo MZ, Huang YG, Ma WH, et al. Expert recommendations
for tracheal intubation in critically ill patients with the Noval
Coronavirus disease 2019. Chin Med Sci J 2020. doi: 10.
24920/003724.
21. Tran DTT, Newton EK, Mount VAH, et al. Rocuronium vs.
succinylcholine for rapid sequence intubation: A Cochrane
systematic review. Anaesthesia 2017;72:765-77.
22. Bohrer H, Fleischer F, Werning P. Tussive effect of a fentanyl
bolus administered through a central venous catheter.
Anaesthesia 1990;45:18-21.
23. Wujtewicz M, Dylczyk-Sommer A, Aszkielowicz A, Zdanowski
S, Piwowarczyk S, Owczuk R. COVID-19-What should
anaethesiologists and intensivists know about it? Anaesthesiol
Intensive Ther 2020;52:34-41.
24. Chen X, Liu Y, Gong Y, et al. Perioperative management of
patients infected with the Novel Coronavirus: recommendations
from the Joint Task Force of the Chinese Society of Anesthesiology
and the Chinese Association of Anesthesiologists.
Anesthesiology 2020;132:1307-16.
25. Matava CT, Yu J, Denning S. Clear plastic drapes may be
effective at limiting aerosolization and droplet spray during
extubation: Implications for COVID-19. Can J Anaesth
2020;3;1-3.
26. Malik JS, Jenner C, Ward PA. Maximizing application of the
aerosol box in protecting healthcare workers during the
Covid-19 pandemic. Anaesthesia 2020. doi: 10.1111/anae.
15109.
27. Hui DS, Chow BK, Lo T, et al. Exhaled air dispersion during
high-flow nasal-cannula therapy versus CPAP via different
masks. Eur Respir J 2019;53(4) doi: 10.1183/13993003.02339-
2018
28. Kotoda M, Hishiyama S, Mitsui K, et al. Assessment of the
potential for pathogen dispersal during high-flow nasal
therapy. J Hosp Infect 2020;104:534-7.
29. Simonnet A, Chetboun M, Poissy J, et al. High prevalence
of obesity in severe acute respiratory syndrome Coronavirus-2
(SARS-CoV-2) requiring invasive mechanical ventilation.
Obesity (Silver Spring) 2020. doi: 10.1002/oby.22831.
30. Brewster DJ, Chrimes N, Do TB, et al. Consensus statement:
Safe-Airway Society principles of airway management and
tracheal intubation specific to the COVID-19 adult patient
group. Med J Aust 2020. doi: 10.5694/mja2.50598.
31. Suzuki K, Kusunoki S, Tanigawa K, Shime N. Comparison of
three video laryngoscopes and direct laryngoscopy for
emergency endotracheal intubation: A retrospective cohort
study. BMJ Open 2019;9(3):e024927. doi: 10.1136/bmjopen-
2018-024927.
32. Cook F, Lobo D, Martin M, et al. Prospective validation of a
new airway management algorithm and predictive features
of intubation difficulty. Br J Anaesth 2019;122:245-54.