ABSTRACT
The COVID-19 pandemic is a challenge for health practitioners, where there are many suspected and confirmed patients with COVID-19, including obstetric patients. Perioperative treatment of COVID-19 patients must be under applicable standards, for both patients and the medical personnel. Personal protective equipment is essential for health workers who treat patients with COVID-19 to prevent the transmission of the virus. The method of delivery ideally should be adapted to the clinical condition of the patient. At the same time, the management of anesthesia for patients with cesarean sections should also be adjusted to the patient's clinical condition by taking into consideration the availability of facilities and infrastructure that we have. Through this report, we want to show how we manage COVID-19 in obstetric cases using the available resources in a third-world country.Copyright © 2021 Bali Journal of Anesthesiology. All rights reserved.
ABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) is a respiratory disease that has become the largest pandemic and also could put the heart at risk of dysfunction. Galectin-3 is involved in the inflammatory process that continues with remodeling and eventually fibrosis. Using galectin-3 examination, we could predict the possible worsening of heart function and evaluate data on influencing factors for increased left ventricular end-diastolic volume (LVEDV) which could later progress to heart failure. METHOD(S): This is an observational prospective analytic study in the COVID-19 ICU of Sanglah Hospital, Bali, Indonesia. The study was conducted from June to October 2021. All research subjects had their blood samples taken for galectin-3 levels examination using enzyme-linked immunosorbent assay (ELISA). Subjects were also evaluated for left ventricular end-diastolic volume (LVEDV) with echocardiography, SOFA scores, and troponin I levels. Subjects were treated with COVID-19 standard protocol established by the Ministry of Health. After 72 h post-admission, subjects were re-examined for galectin-3 levels and LVEDV. Data were analyzed using STATATM. RESULT(S): A total of 45 research subjects were analyzed. Bivariate analysis of the difference of galectin-3 and LVEDV was shown to be insignificant (r = 0.08), no correlation was found between galectin-3 level and LVEDV on ICU admission (r = 0.191), and no correlation found between galectin-3 level and LVEDV after 72 h of hospitalization (r=0.197). Multivariate analysis also showed that none of the variables, namely, difference of galectin-3 level, age, gender, troponin I, SOFA, and Charlson scores had statistically significant correlation with LVEDV (p < 0.05). CONCLUSION(S): No significant correlation was found between galectin-3 level and an increase in LVEDV. Copyright © 2022 Marilaeta Cindryani Lolobali, I. M. G. Widnyana, Ni Made Ayu Wulansari, Ida Bagus Rangga Wibhuti, Made Wiryana, Rudyanto Sedono, Aldy Heriwardito.
ABSTRACT
Due to its expression by macrophages, galectin-3 is among the most recently studied biomarkers. It is likely involved in the inflammatory process that leads to remodeling and eventually fibrosis of organs such as the heart, brain, and kidneys. Coronavirus disease 19 (COVID-19) infection causes excessive inflammatory reactions in the whole body, playing a role in the development of fibrosis due to the activation of the galectin-3-macrophage-fibroblast axis. Heart failure or cardiac dysfunction occurred not only due to pro-inflammatory activation but also due to the overactivation of sympathetic nerves and failure of the respiratory system. The latter increases. the possibility of direct infection or necrosis of the heart due to the heart-lung interaction observed in our pilot study. Forty-five intensive care unit (ICU) patients were recruited consecu-tively in this study to be observed their galectin-3 and troponin I levels. This pilot study demonstrates the correlation between galectin-3 as a proinflammatory biomark-er and troponin I as a definitive biomarker for direct heart injury and highlights its potential use in COVID-19 patients. With the assessment of appropriate biomarkers such as cardiac fibro-sis markers, possible worsening of cardiac conditions in COVID-19 patients treated in the ICU can be detected in its early stages.
ABSTRACT
Introduction: Coronavirus disease 2019 (Covid-19) has become a pandemic all over the world. Despite our familiarity with various protection devices, the high incidence among medical personnel is still worrisome. In this review, we provide several perioperative strategies regarding the management of daily cases in the Covid-19 pandemic setting. Methods: We used keywords (((((coronavirus[Title/Abstract]) OR (covid-19[Title/Abstract])) OR (ncov-19[Title/Abstract])) OR (SARS-cov-2[Title/Abstract]))) AND (perioperative[Title/Abstract]) in the National Library of Medicine (NLM) database to find eligible reports. Results: We found 32 articles from the NLM database. After eligibility screening, we found 25 eligible articles describing perioperative management during the Covid-19 pandemic that relates to the staff's safety. All eligible articles stress the importance of the negative-pressurized environment to deal with perioperative care of Covid-19 patients. In general, the use of personal protective equipment (PPE) and video laryngoscopy is also essential. Conclusion: The best protective suit to avoid health-care personnel from getting Covid-19 infection is proper training and self-discipline. This combined with cooperative, honest patients and proper PPE supply is vital in efforts to reduce the spread of the disease. Negative-pressure chambers, both in operating rooms and intensive care units, are essential in this pandemic. Unfortunately, they are not easily available in underdeveloped and developing countries. © 2020 Bali Journal of Anesthesiology ;Published by Wolters Kluwer-Medknow.