Thoracic Surgery Consultations in COVID-19 Critically Ill Patients: Beyond Conservative Approach
Autor: | Mohammed Alshahrani, Sharifah A. Othman, Mohammed A Sabry, Zeead M. AlGhamdi, Farouk Alreshaid, Hatem Elbawab, Yasser Aljehani, Yousif Almubarak, Ayman El-Baz |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Article Subject business.industry RC86-88.9 General surgery Retrospective cohort study Context (language use) Medical emergencies. Critical care. Intensive care. First aid Critical Care and Intensive Care Medicine medicine.disease Tracheal Stenosis 03 medical and health sciences 0302 clinical medicine Pneumothorax Cardiothoracic surgery medicine Mediastinal Emphysema 030212 general & internal medicine medicine.symptom business Complication 030217 neurology & neurosurgery Subcutaneous emphysema Research Article |
Zdroj: | Critical Care Research and Practice, Vol 2021 (2021) Critical Care Research and Practice |
ISSN: | 2090-1313 2090-1305 |
Popis: | Introduction. Iatrogenic pneumothoracis, barotraumas, and tracheoesophageal fistulae, especially after prolonged intubation, and tracheal stenosis are all entities involving thoracic surgeons’ consultation and management. With the surge of COVID-19 cases particularly in the critical care settings, various types of complications have been observed that require intervention from thoracic surgeons. Methods and Materials. A retrospective study was conducted in an academic healthcare institute in the Eastern Province of Saudi Arabia. We included all COVID-19 cases admitted to ICU in the period between March 15, 2020, and August 15, 2020, requiring thoracic surgery consultation and management. Non-COVID-19 critical cases and iatrogenic pneumothorax were excluded. Results. Of 122 patients who were admitted to ICU with COVID-19, 18 patients (14.75%) required thoracic surgery consultation and management. We discovered a significant association between the outcomes and reintubation rates and the rate of pneumothorax occurrence. The survival analysis showed improvement in patients who had thoracostomy tube insertion as a management than the group who were treated conservatively. On the other hand, there was a significant difference between the COVID ICU group who had thoracic complication and those who did not regarding the length of hospital stay. Conclusion. Noniatrogenic pneumothorax, subcutaneous emphysema, and mediastinal emphysema are well-known thoracic entities, but their presence in the context of COVID-19 disease is a harbinger for worse prognosis and outcomes. The presence of pneumothorax may be associated with better prognosis and outcome compared to surgical and mediastinal emphysema. |
Databáze: | OpenAIRE |
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