To the Editor:
We are grateful to Dr. Magoon for the helpful comments on our article [1]. As he pointed out in the letter to the editor, we have not referred to pulmonary-vascular consequences in the patients with COVID-19. Prolonged hypoxia and mechanical ventilation can cause pulmonary hypertension (PH) in patients with COVID-19. PH per se is a significant predictor of adverse cardiopulmonary outcome in surgical patients as reflected by increased postoperative complications in patients with co-existing high-risk clinical and surgical characteristics [2]. Anesthesiologists should provide appropriate anesthesia and analgesia with avoidance of exacerbating factors of PH (e.g., hypoxia, hypercapnia, acidosis, and hypothermia) and with administrating intravenous vasodilators (e.g., milrinone, nitroprusside, and nitroglycerine) [2]. While a specific strategy against PH in patients with COVID-19 has not been established, the use of nitric oxide may be a strategy in addition to the above conventional approaches [3].
The letter from Dr. Magoon reminds us of the importance of pulmonary-vascular consequences during the COVID-19 pandemic.
Funding
The authors have no financial interests in products related to this article.
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References
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