Lung Ultrasound in COVID-19 Infection Screening for Patients With Indication of Emergency Surgery
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 451
- 试验地点
- 1
- 主要终点
- The best cut-off point for lung ultrasound to discriminate suspected cases of active SARS-CoV-2 infection
研究概览
简要总结
The first case of COVID-19 was identified on December 19 and the world is actually experiencing a pandemic. The surgical procedure in patients with SARS-CoV-2 infection involves the exposure of other patients and the group of health workers who face the care of the patient. Thus, screening with lung ultrasound is an alternative to identify patients with an established or suspected infection that requires urgent surgery. Therefore, the aim of this study is to determinate the operational characteristics of lung ultrasound during the screening process for SARS-CoV-2 infection in patients with an indication for urgent surgery.
详细描述
Surgical intervention of a COVID-19 patient involves the exposure of other patients and the group of health workers who face the care of the patient, which generates additional stress and a subsequent catastrophic respiratory and cardiovascular decompensation.
Managing a patient who is going to undergo a surgical procedure as he was infected, makes health care workers and other patients aware from the risk of infection by reinforcing precautions measures. However, it implies the waste of personal protective elements, and a subsequent chance of consuming the limited stocks of those elements.
Li, Y, et al., described transmission of COVID-19 in a thoracic surgery department. They were infected from a single patient, and from three-generation transmission eight more patients and eleven health care workers. 3 out of 9 patients were infected and none of the health care workers died.
Lei et al reported a case series of 34 patients undergoing surgical treatment during the incubation period of COVID-19. They all developed symptoms. 44% of the patients presented dyspnea in the following days and a third presented ARDS. Seven patients (21%) died.
In both reports it is clear that the failure to identify patients as COVID-19 infected patients prevented them from being managed with the proper precautions and preventive measures, and that health care workers did not use adequate personal protective elements. On the other hand, the reported outcome in both series was worse than the outcome in COVID-19 patients who did not required surgical treatment. This corresponds to anecdotal reports of cases in which manifestations occurred after surgery and did not have a favorable clinical course.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Indication for surgery for any reason
- •Coming from the emergency room or hospitalized for less than 72 hours
排除标准
- •Chronic pulmonary disease
- •Heart failure
- •Kidney failure
- •Referred from another hospital with invasive mechanical ventilation
结局指标
主要结局
The best cut-off point for lung ultrasound to discriminate suspected cases of active SARS-CoV-2 infection
时间窗: 14 days
To identify the best cut-off point from lung ultrasound that allows the discrimination of suspected cases of active SARS-CoV-2 infection in patients undergoing an emergency surgical procedure since May 2020 at Fundación Valle del Lili Hospital, Cali, Colombia.
次要结局
- Prevalence of active SARS-CoV-2 infection(14 days)
- Operational characteristics of lung ultrasound(14 days)
- Cut-off point resulting from the lung ultrasound score(14 days)
- Operational characteristics of each of suspicious lung ultrasound findings(14 days)