Response by Nguyen et al to Letter Regarding Article, "Mechanical Thrombectomy in the Era of the COVID-19 Pandemic: Emergency Preparedness for Neuroscience Teams: A Guidance Statement From the Society of Vascular and Interventional Neurology"

• Type of Material: Article
• Authors: Thanh N. Nguyen, Boston University; Raul Nogueira, Emory University; Tudor G. Jovin, Rowan University
• Language: English
• Date: 2020-08-01
• Publisher: Lippincott Williams & Wilkins
• Publication Version: Final Published Version
• Copyright Statement: © 2020 American Heart Association, Inc.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1161/STROKEAHA.120.030629
• Title of Journal or Parent Work: Stroke
• Volume: 51
• Issue: 8
• Start Page: E172
• End Page: E173
• Grant/Funding Information: None declared
• Keywords: Clinical Neurology; Peripheral Vascular Disease; Cardiovascular System & Cardiology; Life Sciences & Biomedicine; General anesthesia; Care; Ischemic stroke; Science & Technology; Neurosciences & Neurology
• Research Categories: Health Sciences, Medicine and Surgery; Biology, Neuroscience; Health Sciences, Health Care Management

Abstract

We thank Drs Sharma and Rasmussen for their thoughtful perspectives on our report on mechanical thrombectomy in the era of COVID-19.1 In thrombectomy candidates with unknown coronavirus disease 2019 (COVID-19) status, we recommend conscious sedation (CS) first line to (1) minimize delays to treatment, (2) optimize patient outcomes,2 (3) conserve ventilator and critical care bed resources, and (4) conserve anesthesiologist and staff exposure to the aerosolizing events of intubation and extubation.1 We agree with the Society for Neuroscience in Anesthesiology & Critical Care recommendations of early notification and joint decision-making with anesthesiologists regarding anesthesia management of thrombectomy candidates. We also agree that general anesthesia (GA) is preferred for patients at risk for airway deterioration (orthopnea, tachypnea, high oxygen requirement), patients unable to protect their airway, patients with active vomiting, agitation, and uncooperative patients.3