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
Jazyk: angličtina
Rok vydání: 2021
Předmět:
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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