Timing of elective tracheotomy and duration of mechanical ventilation among patients admitted to intensive care with severe COVID-19: A multicenter prospective cohort study.
Head Neck
; 43(12): 3743-3756, 2021 12.
Article
em En
| MEDLINE
| ID: mdl-34524714
ABSTRACT
BACKGROUND:
Optimal timing for tracheotomy for critically ill COVID-19 patients requiring invasive mechanical ventilation (IMV) is not established.METHODS:
Multicenter prospective cohort including all COVID-19 patients admitted to intensive care units (ICUs) in 36 hospitals who required tracheotomy during first pandemic wave. With a target emulation trial framework, we studied the causal effects of early (7-10 days) versus late (>10 days) tracheotomy (LT) on time from tracheotomy to weaning, postoperative mortality, and tracheotomy complications.RESULTS:
Of 696 patients, 20.4% received early tracheotomy (ET). ET was associated with faster weaning (hazard ratio [HR] [95% confidence interval, CI] 1.25 [1.00-1.56]) without differences in mortality (HR [95% CI] 0.85 [0.60-1.21]) or complications (adjusted rate ratio [95% CI] 0.56 [0.23-1.33]).CONCLUSIONS:
ET had a similar or lower post-tracheotomy weaning time than LT, potentially shortening IMV and ICU stays, without changing complication or mortality rates in COVID-19 patients.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
/
COVID-19
Tipo de estudo:
Clinical_trials
/
Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article