Perioperative Management of Neonates Born to Mothers with COVID-19 Undergoing Urgent Cardiac Surgery

Abstract

Neonates born to mothers with COVID-2019 are at high risk of SARS-CoV-2 infection, although the direct vertical transmission from mother to fetus have not been documented but the baby may be infected during breast feeding by airborne or droplet infection. The baby should be isolated from infected mother and from other neonates born to healthy mothers. Neonates born with critical and severe cardiac anomalies usually require lifesaving cardiac surgical intervention. The patient’s hemodynamics should be stabilized before surgery. The patient should be considered as a source of SARS-CoV-2 transmission of infection even in the absence of any clinical, laboratory or radiologic evidence of COVID-2019. Medical personnel’s should use personal protective equipment (PPE) especially during intubation, extubation and handling patient secretions. The circuits of cardiopulmonary bypass should be small as possible to decrease the priming volume. This review is focused on anesthetic hemodynamic goals of different congenital heart disease and methods of protection of medical team in operating room and neonatal intensive care unit from transmission of SARS-CoV-2 infection.