Journal article
Pediatric Airway Management in COVID-19 Patients: Consensus Guidelines From the Society for Pediatric Anesthesia's Pediatric Difficult Intubation Collaborative and the Canadian Pediatric Anesthesia Society
Anesthesia and analgesia, Vol.131(1), pp.61-73
07/01/2020
DOI: 10.1213/ANE.0000000000004872
PMCID: PMC7173403
PMID: 32287142
Abstract
The severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]) pandemic has challenged medical systems and clinicians globally to unforeseen levels. Rapid spread of COVID-19 has forced clinicians to care for patients with a highly contagious disease without evidence-based guidelines. Using a virtual modified nominal group technique, the Pediatric Difficult Intubation Collaborative (PeDI-C), which currently includes 35 hospitals from 6 countries, generated consensus guidelines on airway management in pediatric anesthesia based on expert opinion and early data about the disease. PeDI-C identified overarching goals during care, including minimizing aerosolized respiratory secretions, minimizing the number of clinicians in contact with a patient, and recognizing that undiagnosed asymptomatic patients may shed the virus and infect health care workers. Recommendations include administering anxiolytic medications, intravenous anesthetic inductions, tracheal intubation using video laryngoscopes and cuffed tracheal tubes, use of in-line suction catheters, and modifying workflow to recover patients from anesthesia in the operating room. Importantly, PeDI-C recommends that anesthesiologists consider using appropriate personal protective equipment when performing aerosol-generating medical procedures in asymptomatic children, in addition to known or suspected children with COVID-19. Airway procedures should be done in negative pressure rooms when available. Adequate time should be allowed for operating room cleaning and air filtration between surgical cases. Research using rigorous study designs is urgently needed to inform safe practices during the COVID-19 pandemic. Until further information is available, PeDI-C advises that clinicians consider these guidelines to enhance the safety of health care workers during airway management when performing aerosol-generating medical procedures. These guidelines have been endorsed by the Society for Pediatric Anesthesia and the Canadian Pediatric Anesthesia Society.
Details
- Title: Subtitle
- Pediatric Airway Management in COVID-19 Patients: Consensus Guidelines From the Society for Pediatric Anesthesia's Pediatric Difficult Intubation Collaborative and the Canadian Pediatric Anesthesia Society
- Creators
- Clyde T. Matava - Hospital for Sick ChildrenPete G. Kovatsis - The University of Texas Southwestern Medical CenterJennifer K. Lee - Johns Hopkins MedicinePilar Castro - Cleveland ClinicSimon Denning - Hospital for Sick ChildrenJulie Yu - Hospital for Sick ChildrenRaymond Park - Harvard Med Sch, Childrens Hosp Boston, Dept Anesthesiol Perioperat & Pain Med, Boston, MA 02115 USAJustin L. Lockman - Children's Hospital of PhiladelphiaBritta Von Ungern-Sternberg - Univ Western Australia, Dept Anesthesiol & Pain Management, Crawley, AustraliaStefano Sabato - Royal Children's HospitalLisa K. Lee - University of California, Los AngelesIhab Ayad - University of California, Los AngelesSam Mireles - Stanford UniversityDavid Lardner - Johns Hopkins MedicineSimon Whyte - Cleveland ClinicJudit Szolnoki - Children's Hospital ColoradoNarasimhan Jagannathan - The University of Western AustraliaNicole Thompson - Shriners Hosp Children, Dept Anesthesiol, Chicago, IL USAMary Lyn Stein - Johns Hopkins UniversityNicholas Dalesio - Johns Hopkins MedicineRobert Greenberg - Johns Hopkins MedicineJohn McCloskey - Johns Hopkins MedicineJames PeytonFaye Evans - Harvard Med Sch, Childrens Hosp Boston, Dept Anesthesiol Perioperat & Pain Med, Boston, MA 02115 USABishr Haydar - University of MichiganPaul Reynolds - University of MichiganFranklin Chiao - Cornell UniversityBrad Taicher - Duke UniversityThomas Templeton - Wake Forest Sch Med, Dept Anesthesiol, Winston Salem, NC 27101 USATarun Bhalla - Akron Children's HospitalVidya T. Raman - Nationwide Children's HospitalAnnery Garcia-Marcinkiewicz - Childrens Hosp Philadelphia, Dept Anesthesiol & Crit Care Med, Philadelphia, PA 19104 USAJorge Galvez - Children's Hospital of PhiladelphiaJonathan Tan - Children's Hospital of PhiladelphiaMohamed Rehman - Children's Hospital of PhiladelphiaChristy Crockett - Vanderbilt UniversityPatrick Olomu - The University of Texas Southwestern Medical CenterPeter Szmuk - Univ Texas SouthWestern & Childrens Hlth Syst Tex, Dept Anesthesiol & Pain Management, Dallas, TX USAChris Glover - Texas Children's HospitalMaria Matuszczak - Univ Texas Houston, Sch Med, Dept Anesthesiol, Houston, TX 77030 USAIgnacio Galvez - Hospital Universitario Son EspasesAgnes Hunyady - Seattle Children's HospitalDavid Polaner - University of WashingtonCheryl Gooden - Yale New Haven HospitalGrace Hsu - Children's Hospital of PhiladelphiaHarshad Gumaney - Children's Hospital of PhiladelphiaCaroline Perez-Pradilla - Casa del Niño Hospital InfantilEdgar E. Kiss - The University of Texas Southwestern Medical CenterMary C. Theroux - Thomas Jefferson UniversityJennifer Lau - Children's Hospital of Los AngelesSaeedah Asaf - Arkansas Children's HospitalPablo Ingelmo - Montreal Children's HospitalThomas Engelhardt - Montreal Children's HospitalMonica Hervias - Hospital General Universitario Gregorio MarañónEric Greenwood - Hospital for Sick ChildrenLuv Javia - Hospital General Universitario Gregorio MarañónNicola Disma - Istituto Giannina GasliniMyron Yaster - University of Colorado Anschutz Medical CampusJohn E. Fiadjoe - Children's Hospital of PhiladelphiaPeDI-Collaborative
- Resource Type
- Journal article
- Publication Details
- Anesthesia and analgesia, Vol.131(1), pp.61-73
- DOI
- 10.1213/ANE.0000000000004872
- PMID
- 32287142
- PMCID
- PMC7173403
- NLM abbreviation
- Anesth Analg
- ISSN
- 0003-2999
- eISSN
- 1526-7598
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 13
- Language
- English
- Date published
- 07/01/2020
- Academic Unit
- Anesthesia
- Record Identifier
- 9984656592902771
Metrics
9 Record Views