AI Article Synopsis
- An elderly lady with hypertension was diagnosed with COVID-19 pneumonia, leading to respiratory issues that improved with treatment.
- After 4 days of recovery, she developed a life-threatening mesenteric artery thrombosis that required emergency surgery due to complications like intestinal obstruction.
- Key challenges during the surgery included managing her pneumonia, ensuring proper ventilation, and overcoming technical difficulties with protective equipment, highlighting the need for infection prevention and optimized oxygenation.
Article Abstract
An elderly hypertensive lady presented with fever, respiratory symptoms, and mild abdominal discomfort and was diagnosed to have COVID-19 pneumonia. Respiratory symptoms improved with steroids, awake proning, high flow nasal cannula oxygen therapy and antibiotics. After 4 days, she developed non-occlusive superior mesenteric artery thrombosis, which initially responded to anticoagulants but was complicated on tenth day by intestinal obstruction necessitating emergency surgery. Challenges encountered perioperatively were multi systemic involvement, pneumonia, ventilation- perfusion mismatch, sepsis along with technical difficulties like fogging of goggles, stuck expiratory valve on anesthesia machine, inaudibility through stethoscope and discomfort due to personal protective equipment. Perioperative focus should be on infection prevention, maintenance of hemodynamics, and optimization of oxygenation with preoperative high flow nasal cannula oxygen therapy. Ultrasound lung helps in correct placement of endotracheal tube. We recommend daily machine check, taping of N95 mask to face and ambient operation theatre temperatures of 20-22°C to reduce technical problems.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8098869 | PMC |
| http://dx.doi.org/10.4103/jpgm.JPGM_790_20 | DOI Listing |
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