Anesthetic management of rhinoorbitocerebral mucormycosis; Focus on challenges


Karaaslan E.

JOURNAL DE MYCOLOGIE MEDICALE, cilt.29, sa.3, ss.219-222, 2019 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 29 Sayı: 3
  • Basım Tarihi: 2019
  • Doi Numarası: 10.1016/j.mycmed.2019.07.001
  • Dergi Adı: JOURNAL DE MYCOLOGIE MEDICALE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.219-222
  • İnönü Üniversitesi Adresli: Evet

Özet

Mucormycosis is a progressive, opportunistic fungal infection with a high risk of mortality. Also mucormycosis may attack any organ system and may be accompanied by hemodynamic instability and difficult airway management. This study aimed to evaluate the anesthetic management of patients undergoing surgical resection for rhino-orbito-cerebral mucormycosis (ROC). The study evaluated 12 patients that underwent surgical resection for ROC mucormycosis under general anesthesia. Demographic characteristics, hemodynamic parameters, invasive monitoring methods, surgical procedures, hospital records, and mortality rates were reviewed for each patient. The patients had a median age of 58 (range, 5-86) years. Two patients had an American Society of Anesthesiologists (ASA) score of II while the remaining 10 patients had a score of III. Eleven (91.7%) patients had a diagnosis of rhino-orbital mucormycosis and 1 (8.3%) patient was diagnosed with ROC mucormycosis. Most common comorbidity was DM (n=8), followed by hematological malignancy (n=4), solid organ malignancy (n=3), and kidney transplantation (n=2). Invasive arterial monitoring was performed in 7 and central venous cannulation was performed in 5 patients. Six patients were transferred to the intensive care unit (ICU) and the mortality rate was 25% with an average mortality time was 7 days in 3 cases.