<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1726-6718</journal-id>
<journal-title><![CDATA[Revista Cubana de Anestesiología y Reanimación]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Cuban de Anestesiol y Reanim]]></abbrev-journal-title>
<issn>1726-6718</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1726-67182023000100007</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Manejo anestésico de gestantes con la COVID-19 en un centro de nivel terciario]]></article-title>
<article-title xml:lang="en"><![CDATA[Anesthetic Management of Pregnant Women with COVID-19 in a Tertiary-Level Center]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vasallo Comendeiro]]></surname>
<given-names><![CDATA[Víctor José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guzman Martínez]]></surname>
<given-names><![CDATA[Juan Karel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Riveron Acosta]]></surname>
<given-names><![CDATA[Yunierkis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gamboa]]></surname>
<given-names><![CDATA[Luis Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro Pozo]]></surname>
<given-names><![CDATA[Adel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Militar Central &#8220;Dr. Luis Díaz Soto&#8221;  ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>22</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1726-67182023000100007&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1726-67182023000100007&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1726-67182023000100007&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  Se exponen los resultados de la atención anestesiológica en un Centro de Carácter Provincial, destinado a la cirugía obstétrica de pacientes gestantes tributarias de cesárea y enfermas por la COVID-19.  Objetivo:  Mostrar los resultados de una etapa de trabajo, bajo situación epidemiológica excepcional y durante la existencia de más de una cepa circulante de SARS-CoV 2.  Métodos:  Se realizó una investigación descriptiva, longitudinal, prospectiva; se incluyeron 70 embarazadas diagnosticadas con la COVID-19 y diverso grado de afectación pulmonar y sistémica.  Resultados:  Se consideraron graves 49 (85,96 %), se empleó la anestesia general orotraqueal en 54 (97,73 %), resultaron fallecidas en el posoperatorio 14 (26,31 %) y en el transoperatorio 1 (1,75 %). Del total arribaron ventiladas a la Unidad Quirúrgica 33 (57,89 %) y 49 (85,96 %) presentaron hipoxemia severa al arribo del quirófano. Se logró extubar al final de la intervención solo a 21 (36,84 %), únicamente se efectuaron tres anestesias regionales. El distrés respiratorio en 39 (68,42 %) casos, el fallo circulatorio en 17 (29,82 %) y la presencia de derrames pericárdicos en 13 (22,80 %) casos, fueron los hallazgos asociados. El tiempo entre diagnóstico y decisión de cesárea en beneficio materno fue de 2 días promedio.  Conclusiones:  Se mostraron los resultados de una etapa de trabajo, bajo situación epidemiológica excepcional, durante la existencia de más de una cepa circulante de SARS-CoV 2. La mayoría de las pacientes atendidas requirieron ventilación invasiva, la anestesia general fue la técnica a emplear, la disfunción pulmonar asociado a la falla cardiocirculatoria fueron condiciones presentes y determinantes del resultado, el cumplimiento de las medidas de bioseguridad evitó el contagio del personal durante todo el período.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  The results of anesthesiological care are presented as it was provided in a provincial center for obstetric surgery of pregnant patients candidates for a cesarean section and who were ill with COVID-19.  Objective:  To show the results of a working stage, under an exceptional epidemiological situation and during the existence of more than one circulating strain of SARS-CoV-2.  Methods:  A descriptive, longitudinal and prospective study was carried out. Seventy pregnant women diagnosed with COVID-19 and varying degrees of pulmonary and systemic involvement were included.  Results:  Forty-nine (85.96 %) were considered as severe cases, orotracheal general anesthesia was used in 54 (97.73 %), 14 (26.31 %) died postoperatively and one (1.75 %) died during surgery. Of the total, 33 (57.89 %) were ventilated on arrival to the surgical unit and 49 (85.96 %) presented severe hypoxemia on arrival to the operating room. Only 21 (36.84 %) were extubated at the end of the operation and only three regional anesthetic procedures were performed. Respiratory distress in 39 (68.42 %) cases, circulatory failure in 17 (29.82 %) cases and the presence of pericardial effusions in 13 (22.80 %) cases were the associated findings. The time between diagnosis and decision for a cesarean section based on maternal benefit was two days on average.  Conclusions:  The results of a working stage under an exceptional epidemiological situation and during the existence of more than one circulating strain of SARS-CoV-2 were shown. Most of the attended patients required invasive ventilation. General anesthesia was the technique to be used. Pulmonary dysfunction in association with cardiocirculatory failure were present conditions that determined the results. Compliance with biosafety measures prevented the staff contagion during the entire period.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[COVID-19]]></kwd>
<kwd lng="es"><![CDATA[anestesia general]]></kwd>
<kwd lng="es"><![CDATA[técnica anestésica muerte materna]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[general anesthesia]]></kwd>
<kwd lng="en"><![CDATA[anesthetic technique]]></kwd>
<kwd lng="en"><![CDATA[maternal]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mujica]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Sternberg]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Solis]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Wand]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Carrasco]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Henao-Martínez]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Defusing COVID-19: Lessons Learned from a Century of Pandemics]]></article-title>
<source><![CDATA[Trop Med Infect Dis]]></source>
<year>2020</year>
<volume>5</volume>
<numero>4</numero>
<issue>4</issue>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kotlar]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Gerson]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Petrillo]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Langer]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Tiemeier]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review]]></article-title>
<source><![CDATA[Reprod Health]]></source>
<year>2021</year>
<volume>18</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[López Bernal]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Andrews]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Gower]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Gallagher]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Simmons]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Thelwall]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effectiveness of Covid-19 Vaccines against the B.1.617.2 (delta) variant]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2021</year>
<volume>385</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>585-94</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mirbeyk]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Saghazadeh]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Rezaei]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A systematic review of pregnant women with COVID-19 and their neonates]]></article-title>
<source><![CDATA[Arch Gynecol Obstet]]></source>
<year>2020</year>
<volume>304</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>5-38</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Velly]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Gayat]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Quintard]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Weiss]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[De Jong]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Cuvillon]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Guidelines: Anaesthesia in the context of COVID-19 pandemic]]></article-title>
<source><![CDATA[Anaesth Crit Care Pain Med]]></source>
<year>2020</year>
<volume>39</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>395-415</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kunnumakkara]]></surname>
<given-names><![CDATA[AB]]></given-names>
</name>
<name>
<surname><![CDATA[Rana]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Parama]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Banik]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Girisa]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Henamayee]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[COVID-19, cytokines, inflammation, and spices: How are they related?]]></article-title>
<source><![CDATA[Life Sci]]></source>
<year>2021</year>
<volume>284</volume>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stawicki]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Jeanmonod]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Miller]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Paladino]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Gaieski]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Yaffee]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The 2019-2020 Novel Coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) Pandemic: A Joint American College of Academic International Medicine-World Academic Council of Emergency Medicine Multidisciplinary COVID-19 Working Group Consensus Paper]]></article-title>
<source><![CDATA[J Glob Infect Dis]]></source>
<year>2020</year>
<volume>12</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>47-93</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Karimi]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Makvandi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Vahedian-Azimi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sathyapalan]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Sahebkar]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effect of COVID-19 on mortality of pregnant and pospartum women: A systematic review and meta-Analysis]]></article-title>
<source><![CDATA[J pregnancy]]></source>
<year>2021</year>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kumar]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Yeni]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Utami]]></surname>
<given-names><![CDATA[NA]]></given-names>
</name>
<name>
<surname><![CDATA[Masand]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Asrani]]></surname>
<given-names><![CDATA[RK]]></given-names>
</name>
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[SARS-CoV-2 infection during pregnancy and pregnancy-related conditions: Concerns, challenges, management and mitigation strategies-a narrative review]]></article-title>
<source><![CDATA[J Infect Public Health]]></source>
<year>2021</year>
<volume>14</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>863-75</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kaye]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Paprottka]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Escudero]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Casabona]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Montes]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Fakin]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS-COVID-19 Considerations Regarding Safety, Feasibility and Impact on Clinical Management]]></article-title>
<source><![CDATA[Aesthetic plastic surgery]]></source>
<year>2020</year>
<volume>44</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>1014-42</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Landau]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Bernstein]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ring L Anesthesia Considerations for Pregnant People With COVID-19 Infection]]></article-title>
<collab>E</collab>
<source><![CDATA[Clin Obstet Gynecol]]></source>
<year>2022</year>
<volume>65</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>179-88</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Katz]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Bateman]]></surname>
<given-names><![CDATA[BT]]></given-names>
</name>
<name>
<surname><![CDATA[Kjaer]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Turner]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
<name>
<surname><![CDATA[Spence]]></surname>
<given-names><![CDATA[NZ]]></given-names>
</name>
<name>
<surname><![CDATA[Habib]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Society for Obstetric Anesthesia and Perinatology Coronavirus Disease 2019 Registry: An Analysis of Outcomes Among Pregnant Women Delivering During the Initial Severe Acute Respiratory Syndrome Coronavirus-2 Outbreak in the United States]]></article-title>
<source><![CDATA[Anesth Analg]]></source>
<year>2021</year>
<volume>133</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>462-73</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
