Elective Tracheostomy in COVID-19 Patients: A Retrospective Case Series
DOI:
https://doi.org/10.25751/rspa.20118Keywords:
Tracheostomy, COVID-19, Personal Protective Equipment, Intensive Care Units, Coronavirus Infections, Ventilation/methodsAbstract
The COVID-19 outbreak represents a global health threat due to the unprecedented number of patients admitted to intensive care units and the overwhelming need for mechanical ventilation. Performing a tracheostomy in COVID-19 patients represents a risk for patients and healthcare workers. We report a case series of 10 patients with COVID-19 who underwent elective open tracheostomies in a negative pressure operating room, carried out by an experienced multidisciplinary team. They were tracheostomized after a mean intubation period of 18.6 days (range, 13-23 days). Only one patient developed postoperative complications and no viral transmission to health care workers was documented. Hence, our experience supports the safety of tracheostomy in COVID-19 patients, provided that meticulous planning and strict safety recommendations are followed.
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References
World Health Organization. Coronavirus disease (COVID-19) outbreak. [accessed Apr 2020] Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
Worldometer. COVID-19 Coronavirus Outbreak. [accessed May 2020] Available from: https://www.worldometers.info/coronavirus/
World Health Organization. Rational use of personal protective equipment (PPE) for coronavirus disease (COVID-19). [accessed Jun 2020] Available from: https://apps.who.int/iris/bitstream/handle/10665/331498/WHO-2019-nCoVIPCPPE_
use-2020.2-eng.pdf
Rhodes A, Ferdinande P, Flaatten H, Guidet B, Metnitz PG, Moreno RP. The variability of critical care bed numbers in Europe. Intensive Care Med. 2012;38:1647–53. doi: 10.1007/s00134-012-2627-8.
Trouillet JL, Collange O, Belafia F, Blot F, Capellier G, Cesareo E, et al. Tracheotomy in the intensive care unit: Guidelines from a French expert panel: The French Intensive Care Society and the French Society of Anaesthesia and Intensive Care Medicine. Anaesth Crit Care Pain Med. 2018;37:281-94. doi: 10.1016/j.accpm.2018.02.012
Schultz P, Morvan JB, Fakhry N, Morinière S, Vergez S, Lacroix C, et al. French consensus regarding precautions during tracheostomy and post-tracheostomy care in the context of COVID-19 pandemic. Eur Ann Otorhinolaryngol Head Neck Dis. 2020;137:167-9. doi: 10.1016/j.anorl.2020.04.006.
Tay JK, Khoo ML, Loh WS. Surgical Considerations for Tracheostomy During the COVID-19 Pandemic: Lessons Learned From the Severe Acute Respiratory Syndrome Outbreak. JAMA Otolaryngol Head Neck Surg. 2020 (in press). doi: 10.1001/jamaoto.2020.0764.
Jacob T, Walker A, Mantelakis A, Gibbins N, Keane O. A framework for open tracheostomy in COVID-19 patients.Clin Otolaryngol. 2020 (in press). doi: 10.1111/coa.13549.O
He, F, Deng, Y, Li, W. Coronavirus disease 2019: What we know? J Med Virol.2020 (in press). doi: 10.1002/jmv.25766.
Turri-Zanoni M, Battaglia P, Czaczkes C, Pelosi P, Castelnuovo P, Cabrini L. Elective tracheostomy during mechanical ventilation in patients affected by covid-19: preliminary case series from Lombardy, Italy. Otolaryngol Head Neck
Surg. 2020 (in press). doi: 10.1177/0194599820928963.
Freeman BD. Tracheostomy Update: When and How. Crit Care Clin. 2017;33:311–22. doi: 10.1016/j.ccc.2016.12.007.
Cheung NH, Napolitano LM. Tracheostomy: epidemiology, indications, timing, technique, and outcomes. Respir Care. 2014;59:895–919. doi: 10.4187/respcare.02971.
McGrath BA, Brenner M, Warrillow SJ, Pandian V, Arora A, Cameron TS, et al. Tracheostomy in the COVID-19 era: global and multidisciplinary guidance. Lancet Respir Med. 2020 (in press). doi: 10.1016/S2213-2600(20)30230-7.
British Laryngeal Association. Tracheostomy guideline - COVID-19. [accessed Apr 2020] Available from: https://www.britishlaryngological.org/news/tracheostomy-guideline-covid-19
Chiesa-Estomba CM, Lechien JR, Calvo-Henriquez C, Fakhry N, Karkos PD, Peer S, et al. Systematic review of international guidelines for tracheostomy in COVID-19 patients. Oral Oncol. 2020 (in press). doi: 10.1016/j.oraloncology.2020.104844.
Chu J, Yang N, Wei Y, Yue H, Zhang F, Zhao J, et al. Clinical characteristics of 54 medical staff with COVID-19: A retrospective study in a single center in Wuhan, China. J Med Virol. 2020;92:807-13. doi: 10.1002/jmv.25793
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