1. Organizational aspects of pediatric anesthesia and surgery between two waves of Covid-19.
- Author
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Camporesi A, Melloni GEM, Diotto V, Bertani P, La Pergola E, and Pelizzo G
- Subjects
- Adolescent, Caregivers, Child, Child, Preschool, Cohort Studies, Diagnosis-Related Groups, Elective Surgical Procedures statistics & numerical data, Emergencies epidemiology, Female, Hospital Bed Capacity statistics & numerical data, Hospitals, Pediatric statistics & numerical data, Hospitals, University statistics & numerical data, Hospitals, Urban organization & administration, Hospitals, Urban statistics & numerical data, Humans, Infant, Infant, Newborn, Infection Control methods, Infectious Disease Transmission, Patient-to-Professional prevention & control, Italy epidemiology, Male, Nasopharynx virology, Patients, Symptom Assessment, Tertiary Care Centers statistics & numerical data, Young Adult, Anesthesia Department, Hospital organization & administration, Appointments and Schedules, COVID-19 epidemiology, COVID-19 Nucleic Acid Testing statistics & numerical data, Hospitals, Pediatric organization & administration, Hospitals, University organization & administration, Pandemics, SARS-CoV-2 isolation & purification, Surgery Department, Hospital organization & administration, Surgical Procedures, Operative statistics & numerical data, Tertiary Care Centers organization & administration
- Abstract
Background: The initial wave of the Covid-19 pandemic has hit Italy, and Lombardy in particular, with violence, forcing to reshape all hospitals' activities; this happened even in pediatric hospitals, although the young population seemed initially spared from the disease. "Vittore Buzzi" Children's Hospital, which is a pediatric/maternal hospital located in Milan (Lombardy Region), had to stop elective procedures-with the exception of urgent/emergent ones-between February and May 2020 to leave space and resources to adults' care. We describe the challenges of reshaping the hospital's identity and structure, and restarting pediatric surgery and anesthesia, from May on, in the most hit area of the world, with the purpose to avoid and contain infections. Both patients and caregivers admitted to hospital have been tested for Sars-CoV-2 in every case., Methods: Observational cohort study via review of clinical charts of patients undergoing surgery between 16th May and 30th September 2020, together with SARS-CoV -2 RT-PCR testing outcomes, and comparison to same period surgeries in 2019., Results: An increase of approximately 70% in pediatric surgeries (OR 1.68 [1.33-2.13], P < .001) and a higher increase in the number of surgeries were reported (OR 1.75 (1.43-2.15), P < .001). Considering only urgent procedures, a significant difference in the distribution of the type of surgery was observed (Chi-squared P-value < .001). Sars-CoV-2-positive patients have been 0.8% of total number; 14% of these was discovered through caregiver's positivity., Conclusion: We describe our pathway for safe pediatric surgery and anesthesia and the importance of testing both patient and caregiver., (© 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
- Published
- 2021
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