LitCovid-sentences  

PMC:7337742 / 4464-13197 JSONTXT 12 Projects

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Id Subject Object Predicate Lexical cue
T45 0-21 Sentence denotes MATERIALS AND METHODS
T46 22-209 Sentence denotes The four adult cardiac and vascular surgery hospitals identified as hubs were the Centro Cardiologico Monzino (Monzino), San Raffaele Hospital, Legnano Hospital and Poliambulanza Brescia.
T47 210-285 Sentence denotes Each hub had its own spokes for cardiac and vascular surgery [16] (Fig. 1).
T48 286-345 Sentence denotes San Donato Hospital was the paediatric cardiac surgery hub.
T49 346-355 Sentence denotes Figure 1:
T50 357-648 Sentence denotes Diagram of the hub-and-spoke system. (A) Interconnections between cardiovascular surgery hubs that cooperate and exchange information during weekly briefings. (B) Interconnections between a cardiac surgery hub and its spokes. (C) Interconnections between vascular surgery hub and its spokes.
T51 649-784 Sentence denotes The surgical pathways had three simultaneous surgical teams on call at all times (two independent cardiac teams and one vascular team).
T52 785-985 Sentence denotes Three different pathways were created: one for COVID-19-negative patients (green path), one for patients waiting for the screening result (pink path) and one for COVID-19-positive patients (red path).
T53 986-1135 Sentence denotes The postoperative ICU was split into two areas by a new dividing wall to create physical separation between COVID-19-positive and -negative patients.
T54 1136-1244 Sentence denotes All procedures were carried out according to shared Italian Society of Cardiac Surgery Recommendations [17].
T55 1246-1285 Sentence denotes Hub-and-spoke and regional coordination
T56 1286-1338 Sentence denotes The first step was to coordinate the different hubs.
T57 1339-1455 Sentence denotes To ensure sharing of the workload, resources and surgical priorities, a weekly briefing was held among all the hubs.
T58 1456-1823 Sentence denotes The goal was to obtain an update on the number of ICU beds available among the hubs, because the access rate to each area was unprecedented and unpredictable (Monzino, up to 11; San Raffaele, up to 20; Legnano, up to eight; and Poliambulanza Brescia, up to six) and on the number of operations to be performed and to share ongoing strategies and surgical indications.
T59 1825-1858 Sentence denotes Surgical priorities and screening
T60 1859-1974 Sentence denotes The second step involved setting up a new surgical waiting list that was shared between the hub and its own spokes.
T61 1975-2086 Sentence denotes In the pre-COVID-19 era, each hospital scheduled its own referred patients using an institutional waiting list.
T62 2087-2479 Sentence denotes This waiting list always took into account the recommendations of the National Health Care System: high priority patients, i.e. those with rapidly progressing diseases, were in class A (mandatory hospitalization within 30 days), whereas class B–D patients had less severe clinical presentations, were without priority and were on 60-day, 180-day and 12-month waiting lists, respectively [18].
T63 2480-2684 Sentence denotes At present, in this war-like reality, only class A cases, defined as ND, were included on a new hub-and-spoke shared waiting list and were treated independently from the cases deemed urgent and emergency.
T64 2685-2956 Sentence denotes The overall criteria listed in Table 1 were defined by a task force of expert cardiovascular surgeons from all hub-and-spoke networks and were in agreement with EuroSCORE emergency/urgent definitions and in agreement with Italian Health Organization recommendations [19].
T65 2957-2965 Sentence denotes Table 1:
T66 2967-3081 Sentence denotes Definitions of emergency, urgent and non-deferrable cardiac and vascular cases in the coronavirus disease 2019 era
T67 3082-3104 Sentence denotes Pathology Indications
T68 3105-3244 Sentence denotes Aortic disease Acute aortic dissection/intramural haematoma (exclusion criteria: age >80 years; coma; stroke; visceral organ malperfusion)
T69 3245-3277 Sentence denotes Ascending aortic aneurysm ≥60 mm
T70 3278-3388 Sentence denotes Ascending aortic aneurysm 55–60 mm in Marfan syndrome, yearly growth >5 mm, uncontrolled arterial hypertension
T71 3389-3475 Sentence denotes Severe aortic stenosis Symptomatic for syncope, angina, NYHA functional class IIIb–IV
T72 3476-3589 Sentence denotes Severe aortic regurgitation Acute pulmonary oedema with left ventricular dysfunction or haemodynamic instability
T73 3590-3664 Sentence denotes Severe mitral stenosis Haemodynamic instability or acute pulmonary oedema
T74 3665-3763 Sentence denotes Acute mitral regurgitation Papillary muscle or chordal rupture determining acute pulmonary oedema
T75 3764-3839 Sentence denotes Cardiac ischaemic disease Cardiac rupture or acute interventricular defect
T76 3840-3867 Sentence denotes Untreatable unstable angina
T77 3868-3907 Sentence denotes Left main coronary artery stenosis >70%
T78 3908-4003 Sentence denotes Subocclusive stenosis of left main coronary artery or anterior interventricular coronary artery
T79 4004-4055 Sentence denotes Acute endocarditis Emergency (guidelines criteria)
T80 4056-4084 Sentence denotes Urgent (guidelines criteria)
T81 4085-4123 Sentence denotes Prosthesis dysfunctions Heart failure
T82 4124-4151 Sentence denotes Urgent if non-dischargeable
T83 4152-4178 Sentence denotes Masses Left atrial myxoma
T84 4179-4214 Sentence denotes Other masses with high embolic risk
T85 4215-4235 Sentence denotes Acute limb ischaemia
T86 4236-4253 Sentence denotes Ruptured aneurysm
T87 4254-4298 Sentence denotes Chronic limb ischaemia Leriche III–IV grade
T88 4299-4351 Sentence denotes Thoracic and thoraco-abdominal aorta Diameter >7 cm
T89 4352-4384 Sentence denotes Rapid growth (>1 cm in 6 months)
T90 4385-4444 Sentence denotes Lesion instability at CT scan (blister, fissuring thrombus)
T91 4445-4478 Sentence denotes Abdominal aorta Diameter >6.5 cm
T92 4479-4511 Sentence denotes Rapid growth (>1 cm in 6 months)
T93 4512-4571 Sentence denotes Lesion instability on CT scan (blister, fissuring thrombus)
T94 4572-4601 Sentence denotes Carotid stenosis Symptomatic
T95 4602-4645 Sentence denotes Stenosis >90%, monolateral and asymptomatic
T96 4646-4662 Sentence denotes Ulcerated plaque
T97 4663-4693 Sentence denotes CT: computed tomography; NYHA:
T98 4694-4721 Sentence denotes New York Heart Association.
T99 4722-4918 Sentence denotes Each urgent or scheduled patient had a mandatory screening for SARS-CoV-2, which always included a chest computed tomography (CT) scan, nasal swab, corporal temperature monitoring and blood tests.
T100 4919-5154 Sentence denotes The clinical discussion and daily surgical programme for ND patients included all members of the telematic heart team (THT), one goal being to allow surgeons from the spokes to perform surgery on their own referred patients in the hub.
T101 5155-5403 Sentence denotes Daily morning briefings were held internally at the Monzino hospital to monitor every aspect of all in-patients (COVID-19 status, number of available beds) and to share news from the Health Care Lombardy Regional System and the national government.
T102 5405-5425 Sentence denotes Pathway organization
T103 5426-5585 Sentence denotes Each new patient was considered COVID-19-positive and kept isolated in a dedicated hospital area called the ‘pink area’ while waiting for the screening result.
T104 5586-5843 Sentence denotes If the screening result was negative (negative medical history for suspected contact, absence of fever or interstitial pneumonia on a chest CT scan, negative results from the nasal swab), the patient was transferred to the ‘green area’ (COVID-19-free area).
T105 5844-6215 Sentence denotes If the test results were positive (chest CT scan indicative of interstitial pneumonia and/or positive results from the nasal swab), the patient was transferred to a dedicated zone called the ‘red area’, a separate zone with physical barriers and heavy use of personal protective equipment to protect working personnel, where only patients with COVID-19 were hospitalized.
T106 6217-6238 Sentence denotes Emergency and urgency
T107 6239-6463 Sentence denotes In case of emergency or urgency (Fig. 2), the on-call surgeon could choose between two strategies: either wheel the patient rapidly to the operating room or keep the patient in the emergency room (ER) for further assessment.
T108 6464-6555 Sentence denotes In both cases, the nasal swab and the CT scan were performed in the shortest possible time.
T109 6556-6707 Sentence denotes Thanks to our internal laboratory, the swabs results were obtained within 3 h or before the end of the operation in the case of an emergency procedure.
T110 6708-6717 Sentence denotes Figure 2:
T111 6719-6761 Sentence denotes Flow chart for emergency and urgent cases.
T112 6762-6815 Sentence denotes COVID: coronavirus disease; ICU: intensive care unit.
T113 6816-7018 Sentence denotes In cases of emergency surgery, the patient was considered and treated as positive for SARS-CoV-2 by the health care staff, who wore personal protective equipment, until screening results were available.
T114 7019-7149 Sentence denotes At the end of the procedure, depending on the screening result, the patient was transferred to the appropriate dedicated ICU area.
T115 7150-7302 Sentence denotes In cases of urgent surgery, the patient was screened and held in a pink area (in the ER), isolated from other patients until the results were available.
T116 7303-7482 Sentence denotes If the results of the screening test were positive, the surgical indication had to be confirmed by the THT and the procedure was possibly postponed if clinical conditions allowed.
T117 7484-7507 Sentence denotes Non-deferrable patients
T118 7508-7566 Sentence denotes A different flow chart was designed for ND cases (Fig. 3).
T119 7567-7599 Sentence denotes Cases were discussed in the THT.
T120 7600-7727 Sentence denotes If the patient presented from home, the screening was performed upon arrival and the patient was kept in the pink waiting area.
T121 7728-7902 Sentence denotes Once the screening result was available, non-COVID-19 patients were transferred to the green area, whereas patients with COVID-19 were evaluated according to clinical status:
T122 7903-8104 Sentence denotes Rehospitalization was foreseen after the quarantine period with a new COVID-19 screening or, in the case of a poor clinical condition, the patient was transferred to a COVID-19 centre for further care.
T123 8105-8114 Sentence denotes Figure 3:
T124 8116-8152 Sentence denotes Flow chart for non-deferrable cases.
T125 8153-8200 Sentence denotes COVID: coronavirus disease; OR: operating room.
T126 8201-8393 Sentence denotes If the ND patient was referred from another hospital (a spoke), a first COVID screening was performed before arranging transfer: a second screening was performed upon arrival in the pink area.
T127 8394-8474 Sentence denotes Negative patients were moved to the green area to wait for a surgical procedure.
T128 8475-8569 Sentence denotes Patients positive for COVID-19 were transferred back to the spoke/COVID-19 centre for therapy.
T129 8570-8733 Sentence denotes The THR discussion, with the reasons for acceptance or refusal of the surgical indications, was recorded in a dedicated database that was updated by the hub staff.