Outcomes After Tracheostomy in COVID-19 Patients.
Ann Surg
; 272(3): e181-e186, 2020 09 01.
Article
em En
| MEDLINE
| ID: mdl-32541213
ABSTRACT
OBJECTIVE:
To determine the outcomes of patients undergoing tracheostomy for COVID-19 and of healthcare workers performing these procedures.BACKGROUND:
Tracheostomy is often performed for prolonged endotracheal intubation in critically ill patients. However, in the context of COVID-19, tracheostomy placement pathways have been altered due to the poor prognosis of intubated patients and the risk of transmission to providers through this highly aerosolizing procedure.METHODS:
A prospective single-system multi-center observational cohort study was performed on patients who underwent tracheostomy after acute respiratory failure secondary to COVID-19.RESULTS:
Of the 53 patients who underwent tracheostomy, the average time from endotracheal intubation to tracheostomy was 19.7 daysâ±â6.9 days. The most common indication for tracheostomy was acute respiratory distress syndrome, followed by failure to wean ventilation and post-extracorporeal membrane oxygenation decannulation. Thirty patients (56.6%) were liberated from the ventilator, 16 (30.2%) have been discharged alive, 7 (13.2%) have been decannulated, and 6 (11.3%) died. The average time from tracheostomy to ventilator liberation was 11.8 daysâ±â6.9 days (range 2-32 days). Both open surgical and percutaneous dilational tracheostomy techniques were performed utilizing methods to mitigate aerosols. No healthcare worker transmissions resulted from performing the procedure.CONCLUSIONS:
Alterations to tracheostomy practices and processes were successfully instituted. Following these steps, tracheostomy in COVID-19 intubated patients seems safe for both patients and healthcare workers performing the procedure.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Respiração Artificial
/
Traqueostomia
/
Cuidados Críticos
/
COVID-19
/
Intubação Intratraqueal
Tipo de estudo:
Clinical_trials
/
Observational_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Ann Surg
Ano de publicação:
2020
Tipo de documento:
Article