ABSTRACT
[This corrects the article DOI: 10.1016/j.pratan.2020.07.004.].
ABSTRACT
Surgical pathway has gained in complexity thanks to the recent COVID-19 pandemic. The anesthetic management of the SARScoV-2 (+) patient imposes several modifications, and remains a work in progress. As a consequence there has been a shift to distant anaesthetic consultations while in-hospital consultations are more difficult to organize. Patients scheduled for surgery may benefit from a preoperative diagnostic testing for SARS coV2 infection if they have been in close contact with a COVID-19 patient, or if they are symptomatic or in case of major surgery. According to the PCR results, patients could have their surgery postponed, or may alternatively follow a specific clinical pathway in the operating and recovery rooms with an adapted anaesthetic plan.
ABSTRACT
Renal impairment is a common complication in patients hospitalized in intensive care unit for acute respiratory distress syndrome (ARDS) due to COVID-19 infection. However, the prevalence of SARS-CoV-2 kidney injury is difficult to estimate worldwide. Several pathophysiological mechanisms are involved, including decreased renal perfusion related to mechanical ventilation, sepsis and cytokines release, as well as direct virus toxicity on proximal tubular cells and podocytes, mediated by angiotensin 2 conversion receptors (ACE 2) and TMPRSS proteases. More than 20 % of ICU COVID-19 patients require extra renal replacement therapy (ERT) for acute renal failure that is made difficult by the hypercoagulable state of these patients, responsible for filter thrombosis.