Cargando…

Urgent Neurosurgical Interventions in the COVID-19–Positive Pediatric Population

BACKGROUND: Urgent neurosurgical interventions for pediatric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are rare. These cases pose additional stress on a potentially vulnerable dysregulated inflammatory response that can place the child at risk of further clinical det...

Descripción completa

Detalles Bibliográficos
Autores principales: Lang, Shih-Shan, Gajjar, Avi A., Tucker, Alexander M., Storm, Phillip B., Rahman, Raphia K., Madsen, Peter J., O'Brien, Aidan, Chiotos, Kathleen, Kilbaugh, Todd J., Huh, Jimmy W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8550883/
https://www.ncbi.nlm.nih.gov/pubmed/34718196
http://dx.doi.org/10.1016/j.wneu.2021.10.155
_version_ 1784591049167994880
author Lang, Shih-Shan
Gajjar, Avi A.
Tucker, Alexander M.
Storm, Phillip B.
Rahman, Raphia K.
Madsen, Peter J.
O'Brien, Aidan
Chiotos, Kathleen
Kilbaugh, Todd J.
Huh, Jimmy W.
author_facet Lang, Shih-Shan
Gajjar, Avi A.
Tucker, Alexander M.
Storm, Phillip B.
Rahman, Raphia K.
Madsen, Peter J.
O'Brien, Aidan
Chiotos, Kathleen
Kilbaugh, Todd J.
Huh, Jimmy W.
author_sort Lang, Shih-Shan
collection PubMed
description BACKGROUND: Urgent neurosurgical interventions for pediatric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are rare. These cases pose additional stress on a potentially vulnerable dysregulated inflammatory response that can place the child at risk of further clinical deterioration. Our aim was to describe the perioperative course of SARS-CoV-2–positive pediatric patients who had required an urgent neurosurgical intervention. METHODS: We retrospectively analyzed pediatric patients aged ≤18 years who had been admitted to a quaternary children's hospital with a positive polymerase chain reaction test result for SARS-CoV-2 virus from March 2020 to October 2021. The clinical characteristics, anesthetic and neurosurgical operative details, surgical outcomes, and non-neurological symptoms were collected and analyzed. RESULTS: We identified 8 SARS-CoV-2–positive patients with a mean age of 8.83 years (median, 8.5 years; range, 0.58–18 years). Of the 8 patients, 6 were male. All children had had mild or asymptomatic coronavirus disease 2109. The anesthetic and surgical courses for these patients were, overall, uncomplicated. All the patients had been admitted to a specialized isolation unit in the pediatric intensive care unit for cardiopulmonary and neurological monitoring. The use of increased protective personal equipment during anesthesia and surgery did not impede a successful neurosurgical operation. CONCLUSIONS: SARS-CoV-2–positive pediatric patients with minimal coronavirus disease 2019–related symptoms who require urgent neurosurgical interventions face unique challenges regarding their anesthetic status, operative delays due to SARS-CoV-2 polymerase chain reaction testing, and requirements for additional protective personal equipment. Despite these clinical challenges, the patients in our study had not experienced adverse postoperative consequences, and no healthcare professional involved in their care had contracted the virus.
format Online
Article
Text
id pubmed-8550883
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Elsevier Inc.
record_format MEDLINE/PubMed
spelling pubmed-85508832021-10-28 Urgent Neurosurgical Interventions in the COVID-19–Positive Pediatric Population Lang, Shih-Shan Gajjar, Avi A. Tucker, Alexander M. Storm, Phillip B. Rahman, Raphia K. Madsen, Peter J. O'Brien, Aidan Chiotos, Kathleen Kilbaugh, Todd J. Huh, Jimmy W. World Neurosurg Original Article BACKGROUND: Urgent neurosurgical interventions for pediatric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are rare. These cases pose additional stress on a potentially vulnerable dysregulated inflammatory response that can place the child at risk of further clinical deterioration. Our aim was to describe the perioperative course of SARS-CoV-2–positive pediatric patients who had required an urgent neurosurgical intervention. METHODS: We retrospectively analyzed pediatric patients aged ≤18 years who had been admitted to a quaternary children's hospital with a positive polymerase chain reaction test result for SARS-CoV-2 virus from March 2020 to October 2021. The clinical characteristics, anesthetic and neurosurgical operative details, surgical outcomes, and non-neurological symptoms were collected and analyzed. RESULTS: We identified 8 SARS-CoV-2–positive patients with a mean age of 8.83 years (median, 8.5 years; range, 0.58–18 years). Of the 8 patients, 6 were male. All children had had mild or asymptomatic coronavirus disease 2109. The anesthetic and surgical courses for these patients were, overall, uncomplicated. All the patients had been admitted to a specialized isolation unit in the pediatric intensive care unit for cardiopulmonary and neurological monitoring. The use of increased protective personal equipment during anesthesia and surgery did not impede a successful neurosurgical operation. CONCLUSIONS: SARS-CoV-2–positive pediatric patients with minimal coronavirus disease 2019–related symptoms who require urgent neurosurgical interventions face unique challenges regarding their anesthetic status, operative delays due to SARS-CoV-2 polymerase chain reaction testing, and requirements for additional protective personal equipment. Despite these clinical challenges, the patients in our study had not experienced adverse postoperative consequences, and no healthcare professional involved in their care had contracted the virus. Elsevier Inc. 2022-02 2021-10-27 /pmc/articles/PMC8550883/ /pubmed/34718196 http://dx.doi.org/10.1016/j.wneu.2021.10.155 Text en © 2021 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Article
Lang, Shih-Shan
Gajjar, Avi A.
Tucker, Alexander M.
Storm, Phillip B.
Rahman, Raphia K.
Madsen, Peter J.
O'Brien, Aidan
Chiotos, Kathleen
Kilbaugh, Todd J.
Huh, Jimmy W.
Urgent Neurosurgical Interventions in the COVID-19–Positive Pediatric Population
title Urgent Neurosurgical Interventions in the COVID-19–Positive Pediatric Population
title_full Urgent Neurosurgical Interventions in the COVID-19–Positive Pediatric Population
title_fullStr Urgent Neurosurgical Interventions in the COVID-19–Positive Pediatric Population
title_full_unstemmed Urgent Neurosurgical Interventions in the COVID-19–Positive Pediatric Population
title_short Urgent Neurosurgical Interventions in the COVID-19–Positive Pediatric Population
title_sort urgent neurosurgical interventions in the covid-19–positive pediatric population
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8550883/
https://www.ncbi.nlm.nih.gov/pubmed/34718196
http://dx.doi.org/10.1016/j.wneu.2021.10.155
work_keys_str_mv AT langshihshan urgentneurosurgicalinterventionsinthecovid19positivepediatricpopulation
AT gajjaravia urgentneurosurgicalinterventionsinthecovid19positivepediatricpopulation
AT tuckeralexanderm urgentneurosurgicalinterventionsinthecovid19positivepediatricpopulation
AT stormphillipb urgentneurosurgicalinterventionsinthecovid19positivepediatricpopulation
AT rahmanraphiak urgentneurosurgicalinterventionsinthecovid19positivepediatricpopulation
AT madsenpeterj urgentneurosurgicalinterventionsinthecovid19positivepediatricpopulation
AT obrienaidan urgentneurosurgicalinterventionsinthecovid19positivepediatricpopulation
AT chiotoskathleen urgentneurosurgicalinterventionsinthecovid19positivepediatricpopulation
AT kilbaughtoddj urgentneurosurgicalinterventionsinthecovid19positivepediatricpopulation
AT huhjimmyw urgentneurosurgicalinterventionsinthecovid19positivepediatricpopulation