Abbonarsi

Guidelines: Anaesthesia in the context of COVID-19 pandemic - 20/07/20

Doi : 10.1016/j.accpm.2020.05.012 
Lionel Velly a, b, , Etienne Gayat c, d, Hervé Quintard g, Emmanuel Weiss h, i, Audrey De Jong e, f, Philippe Cuvillon j, Gérard Audibert k, Julien Amour l, Marc Beaussier m, Matthieu Biais n, o, Sébastien Bloc p, Marie Pierre Bonnet q, r, s, Pierre Bouzat t, Gilles Brezac u, Claire Dahyot-Fizelier v, w, Souhayl Dahmani x, Mathilde de Queiroz y, Sophie Di Maria z, Claude Ecoffey aa, Emmanuel Futier ab, ac, Thomas Geeraerts ad, Haithem Jaber ae, Laurent Heyer af, Rim Hoteit e, Olivier Joannes-Boyau ag, Delphine Kern ah, Olivier Langeron ai, Sigismond Lasocki aj, Yoan Launey ak, Frederic le Saché al, am, an, Anne Claire Lukaszewicz ao, ap, Axel Maurice-Szamburski aq, Nicolas Mayeur ar, Fabrice Michel as, Vincent Minville at, au, Sébastien Mirek av, aw, Philippe Montravers ax, ay, Estelle Morau az, Laurent Muller ba, bb, Jane Muret bc, Karine Nouette-Gaulain bd, Jean Christophe Orban be, Gilles Orliaguet bf, bg, Pierre François Perrigault bh, Florence Plantet bi, Julien Pottecher bj, bk, Christophe Quesnel ay, bl, Vanessa Reubrecht z, Bertrand Rozec bm, Benoit Tavernier bn, Benoit Veber bo, Francis Veyckmans bp, Hélène Charbonneau ar, Isabelle Constant bq, Denis Frasca br, Marc-Olivier Fischer bs, Catherine Huraux bt, Alice Blet d, bu, bv, Marc Garnier ay, bw, bx
a Aix-Marseille University, AP–HM, Department of Anaesthesiology and Critical Care Medicine, University Hospital Timone, 13005 Marseille, France 
b Aix-Marseille University, CNRS, Institut Neuroscience Timone, UMR7289, Marseille, France 
c Department of Anaesthesiology and Critical Care, Lariboisière Hospital, DMU Parabol, AP–HP Nord, University of Paris, Paris, France 
d Inserm UMR-S 942, Cardiovascular Markers in Stress Conditions (MASCOT), University of Paris, Paris, France 
e Department of Anaesthesia and Intensive Care unit, Regional University Hospital of Montpellier, St-Éloi Hospital, Montpellier, France 
f PhyMedExp, University of Montpellier, Inserm U1046, CNRS UMR, 9214, Montpellier, France 
g Intensive Care Unit, Centre Hospitalier Universitaire de Nice, Pasteur 2 Hospital, Nice, France 
h Department of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP–HP Nord, Paris, France 
i Inserm UMR_S1149, Inserm, Université de Paris, Paris, France 
j Department of Anaesthesiology, Beaujon Hospital, CHU Carémeau, Nîmes, France 
k Department of Anaesthesia and Intensive Care, Lorraine University, Nancy University Hospital, 54000 Nancy, France 
l Cardiovascular and Thoracic Surgery Department, Hôpital Privé Jacques-Cartier, 91300 Massy, France 
m Département d’Anesthésie, Institut Mutualiste Montsouris, 75014 Paris, France 
n Department of Anaesthesiology and Critical Care, Pellegrin Hospital, CHU de Bordeaux, Bordeaux, France 
o Inserm UMR-S 1034, Biology of Cardiovascular Diseases, Bordeaux University, Bordeaux, France 
p CMC Ambroise-Paré, Département d’anesthésie, 92200 Neuilly-sur-Seine, France 
q Department of Anaesthesiology and Critical Care, Armand-Trousseau University Hospital, Assistance publique–Hôpitaux de Paris, Paris, France 
r Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Université de Paris, Obstetrical Perinatal and Paediatric Epidemiology Research Team (EPOPé), Inserm INRA, Paris, France 
s Department of Anaesthesiology and Critical Care, Cochin-Port Royal University Hospital, Assistance publique–Hôpitaux de Paris, Paris, France 
t Department of Anaesthesiology and Intensive Care Medicine, Grenoble University Hospital, 38000 Grenoble, France 
u Anaesthesiology, Lenval Children's Hospital, 06200 Nice, France 
v Anaesthesia and Intensive Care, University Hospital of Poitiers, Poitiers, France 
w Inserm UMR1070, Pharmacology of Anti-infective Agents, University of Poitiers, Poitiers, France 
x Department of Anaesthesia and Intensive Care, Robert-Debré University Hospital, AP–HP, DHU PROTECT, Inserm U1141, Paris, France 
y Department of Paediatric Anaesthesia and Intensive Care, Femme–Mère-Enfant Hospital, Lyon, France 
z Department of Anaesthesiology and Critical Care, AP–HP, Hôpital Pitié-Salpêtrière, Paris, France 
aa Department of Anaesthesia and Intensive Care, CHU de Rennes, Inserm UMR 991, CIC 1414, Rennes 1 University, Rennes, France 
ab Department of Anaesthesiology and Critical Care, Estaing Hospital, CHU de Clermont-Ferrand, Clermont-Ferrand, France 
ac Université Clermont Auvergne, CNRS, Inserm U-1103, Clermont-Ferrand, France 
ad Pôle Anesthésie-Réanimation, Inserm, UMR 1214, Toulouse Neuroimaging Centre (ToNIC), université Toulouse 3 – Paul-Sabatier, CHU de Toulouse, 31059 Toulouse, France 
ae Departments of Anaesthesia and Intensive Care, Caen University Hospital, Caen, France 
af Intensive Care Unit, Department of Anaesthesiology and Intensive Care Medicine, Croix-Rousse Hospital, Lyon, France 
ag Service d’Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, 33000 Bordeaux, France 
ah Departments of Anaesthesia and Intensive Care, Children Hospital, University Hospital of Toulouse, Toulouse, France 
ai Department of Anaesthesiology and Critical Care Medicine, Henri-Mondor University Hospital, University Paris-Est Créteil (UPEC), Assistance publique–Hôpitaux de Paris, Paris, France 
aj Department of Anaesthesiology and Critical Care Medicine, UBL Université d’Angers, CHU d’Angers, Angers, France 
ak Department of Anaesthesiology and Critical Care Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France 
al Department of Anaesthesiology and Intensive Care, DMU DREAM, AP–HP, 6 Sorbonne Université, Paris, France 
am Clinique Remusat, 75016 Paris, France 
an Clinique Jouvenet, 75016 Paris, France 
ao University of Lyon, EA 7426: Pathophysiology of Injury-Induced Immunosuppression (PI3), Lyon, France 
ap Department of Anaesthesiology and Critical Care, Neurological hospital, Hospices Civils de Lyon, Lyon, France 
aq Department of Anaesthesia, Clinique Monticelli-Velodrome, GDS, 13008 Marseille, France 
ar Anaesthesiology and intensive care medicine, Clinique Pasteur, 31076 Toulouse, France 
as Department of Paediatric Intensive Care Unit, Assistance publique–Hôpitaux de Marseille, La Timone Hospital, Marseille, France 
at Department of Anaesthesiology and Intensive Care, Toulouse University Hospital, 31432 Toulouse, France 
au Inserm, U1048, Université Paul-Sabatier, Institute of Metabolic and Cardiovascular Diseases, I2MC, 31432 Toulouse, France 
av Department of Anaesthesiology and Intensive Care, Dijon University Hospital, 21079 Dijon, France 
aw U-SEEM, Healthcare Simulation Centre of University Hospital of Dijon, 21079 Dijon, France 
ax Department of Anaesthesiology and Critical Care, CHU Bichat–Claude-Bernard, DMU Parabol, AP–HP Nord, University of Paris, Paris, France 
ay Inserm UMR-S 1152, Epidemiology and Physiopathology of Respiratory Diseases, University of Paris, Paris, France 
az Department of Anaesthesiology and Critical Care Medicine, Hôpital Universitaire Arnaud-de-Villeneuve, Montpellier, France 
ba Department of Anaesthesiology and Intensive Care, Pain and Emergency Medicine, Nîmes-Caremeau University Hospital, Université Montpellier, place du Professeur-Robert-Debré, 30029 Nîmes cedex 9, France 
bb Physiology Department, EA 2992, Faculty of Medicine, Université Montpellier, Montpellier-Nimes University, Nîmes, France 
bc Institut Curie PSL Research University, 75005 Paris, France 
bd Department of Anaesthesiology, Intensive Care and Pain, Institut Curie, 75005 Paris, France 
be Department of Anaesthesiology and Intensive Care Medicine, Nice University Hospital, Nice, France 
bf Surgical Paediatric Intensive Care Unit, Universitary Hospital Necker–Enfants-Malades, Paris, France 
bg EA08 Pharmacologie et Évaluation des Thérapeutiques chez l’Enfant et la Femme Enceinte, Paris Descartes University (Paris V), Paris, France 
bh Department of Anaesthesia and Critical Care Medicine, Montpellier University, Gui-de-Chauliac Hospital, Montpellier, France 
bi Service d’Anesthésie-Réanimation, Clinique Générale, 4, chemin de la Tour-la-Reine, Annecy, France 
bj Department of Anaesthesiology and Critical Care, Les Hôpitaux Universitaires de Strasbourg (HUS), Strasbourg, France 
bk Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France 
bl Department of Anaesthesiology and Critical Care, Tenon Hospital, DMU DREAM, AP–HP, 6 Sorbonne Université School of Medicine, Paris, France 
bm Anesthésie-Réanimation, CHU Nantes, Hôpital Laennec, 1, boulevard Jacques-Monod, 44093 Nantes cedex, France 
bn Department of Anaesthesiology and Critical Care, CHU de Lille, Pôle d’Anesthésie-Réanimation, 59000 Lille, France 
bo Department of Anaesthesiology and Critical Care, Université de Rouen Normandie, Rouen, France 
bp Department of Paediatric Anaesthesia, Jeanne-de-Flandre Hospital, University Hospitals of Lille, Lille, France 
bq Anaesthesiology Department, Hôpital Armand-Trousseau, Sorbonne Université, Assistance publique–Hôpitaux de Paris, DMU DREAM, Sorbonne Université, Paris, France 
br Department of Anaesthesiology and Critical Care, Poitiers University, CHU de Poitiers, Poitiers, France 
bs Department of Anaesthesiology and Critical Care, Normandie Université, UNICAEN, CHU de Caen Normandie, 14000 Caen, France 
bt Department of Anaesthesiology, Clinique des Cèdres, 38130 Échirolles, France 
bu Department of Anaesthesiology, Critical Care and Burn Centre, Lariboisière–Saint-Louis Hospitals, DMU Parabol, AP–HP Nord, University of Paris, Paris, France 
bv University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada 
bw Department of Anaesthesiology and Critical Care, Saint-Antoine Hospital, DMU DREAM, AP–HP, 6 Sorbonne Université, Paris, France 
bx Sorbonne Université School of Medicine, Paris, France 

Corresponding author at: Service d’Anesthésie-Réanimation, Centre Hospitalier Universitaire Timone, 264, rue Saint-Pierre, 13005 Marseille cedex 5, France.Service d’Anesthésie-Réanimation, Centre Hospitalier Universitaire Timone264, rue Saint-PierreMarseille cedex 513005France

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Abstract

Objectives

The world is currently facing an unprecedented healthcare crisis caused by the COVID-19 pandemic. The objective of these guidelines is to produce a framework to facilitate the partial and gradual resumption of intervention activity in the context of the COVID-19 pandemic.

Methods

The group has endeavoured to produce a minimum number of recommendations to highlight the strengths to be retained in the 7 predefined areas: (1) protection of staff and patients; (2) benefit/risk and patient information; (3) preoperative assessment and decision on intervention; (4) modalities of the preanaesthesia consultation; (5) specificity of anaesthesia and analgesia; (6) dedicated circuits and (7) containment exit type of interventions.

Results

The SFAR Guideline panel provides 51 statements on anaesthesia management in the context of COVID-19 pandemic. After one round of discussion and various amendments, a strong agreement was reached for 100% of the recommendations and algorithms.

Conclusion

We present suggestions for how the risk of transmission by and to anaesthetists can be minimised and how personal protective equipment policies relate to COVID-19 pandemic context.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : COVID-19, SARS-CoV-2, Airway management, Infection prevention and control, Personal protective equipment, Viruses


Mappa


 Guidelines from the French Society of Anaesthesia and Intensive Care Medicine (Société française d’anesthésie et de réanimation – SFAR), in collaboration with the Association of French-speaking paediatric anaesthesiologists and intensivists (Association des anesthésistes réanimateurs pédiatriques d’expression française – ADARPEF).
☆☆ Validated by the Board of Directors of SFAR on 29/04/2020.


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Vol 39 - N° 3

P. 395-415 - Giugno 2020 Ritorno al numero
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