Noor Habboosh1 , Benjamin Pomy2 , Joseph Devlin2 , Robyn Macsata2 , Anton Sidawy2 , Bao Ngoc-Nguyen2 and Salim Lala2 *
1George Washington University School of Medicine and Health Sciences, USA 2Department of Surgery, George Washington University Hospital, USAFulltext PDF
Objective: Use of General Endotracheal Anesthesia (GETA) in asymptomatic COVID-19 patients is concerning for a possible precipitation of Systemic Inflammatory Response Syndrome (SIRS) and ultimately respiratory failure. This study evaluates outcomes in patients undergoing urgent surgery with GETA unrelated to their asymptomatic COVID-19 infection. Methods: This is a retrospective, single institution study from March through December 2020. We included asymptomatic Polymerase Chain Reaction (PCR) positive COVID-19 patients who underwent urgent surgery using GETA. Primary outcomes included unplanned reintubation, mechanical ventilation greater than 48 h, bacterial pneumonia, and mortality. Secondary outcomes included Major Cardiac Adverse Events (MACE), Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), and intensive care and hospital length of stay. Results: Twenty-seven patients met inclusion criteria; 12 were trauma activations. There were no unplanned reintubations, 3 patients (11%) required mechanical ventilation greater than 48 h, 1 of which (4%) was diagnosed with bacterial pneumonia, 2 of whom (7%) died. One patient required laparotomy with gastric ulcer ligation for a Gastrointestinal (GI) bleed and remained intubated for open abdomen management. One patient required multiple laparotomies and bowel resections for GI bleed and died from multi-system organ failure. One patient required a decompressive craniotomy after massive trauma and care was withdrawn due to neurologic function. Secondary outcomes are in Table 1. Conclusion: Patients’ morbidity and mortality was more consistent with their underlying clinical presentation and associated surgical procedure, rather than their asymptomatic COVID-19 status. This single institution experience suggests that is may be safe to proceed with urgent surgery if clinically necessary
Habboosh N, Pomy B, Devlin J, Macsata R, Sidawy A, Ngoc-Nguyen B, et al. Urgent Surgery with General Anesthesia Can be a Safe Option in Asymptomatic COVID-19 Positive Patients – A Single Institution Experience. World J Surg Surgical Res. 2022; 5: 1355..