Patient Undergoing Cardiac Surgery after Influenza Pneumonia
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Influenza infection during surgery has been proven to have an impact on the results in terms of lengthened hospital stays and a higher likelihood of admission to a critical care unit. These individuals present an infection control issue in addition to the postoperative consequences. Although it is often recommended to postpone elective surgery until the patient has recovered from active influenza, this may not always be possible in cases of urgency, such as the one in this case. This 63-year-old diabetic man with an inferior wall myocardial infarction and failed thrombolysis was referred to our hospital (a tertiary care facility in South India). When he arrived at the emergency hospital, he was discovered to be in serious respiratory distress with hypoxia (SpO2- 88 percent on room air), cardiogenic shock (BP - 80/50 mmHg, PR - 120/min), and cardiogenic shock. An urgent coronary angiography was performed on him, and it identified serious triple vessel disease. He was moved to a coronary care facility for additional management after having an intra-aortic balloon pump inserted. He experienced a fever, cough, and dyspnea two days prior to this incident, according to his medical history. We examined him for influenza because there was an ongoing pandemic, and the results showed that he had H3N2 infection (which was verified by PCR from endotracheal tube secretion). He was put on oseltamivir and moved to a respiratory isolation room, which was under negative pressure and had medical workers wearing N95 masks for interaction with the patient. His abnormal hemodynamics and triple vascular disease necessitated immediate cardiac bypass surgery. After his third day in the hospital, we transferred him to the operating room, where we made sure that everyone engaged in the procedure had had their annual influenza vaccination and was wearing a N95 mask. His case was heard at the OT's evening session, and it was made sure that no other cases were ongoing at the time. In addition, oseltamivir after exposure prophylaxis was made available to all healthcare professionals (HCP) involved in his treatment. After spending seven days in the hospital, he made a full recovery and was then released. During his stay, we did not observe any influenza spread in hospitals.