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1.
Chinese Journal of Nosocomiology ; 32(10):1464-1467, 2022.
Article in English, Chinese | GIM | ID: covidwho-2011392

ABSTRACT

OBJECTIVE: To investigate the characteristics and influencing factors for Stenotrophomonas maltophilia (SMA) infection in Sanya and analyze the drug resistance so as to provide guidance for prevention and control of infection in medical institutions. METHODS: The hospitalization data were collected from the patients with SMA infection who were hospitalized in three tertiary general hospitals of Sanya from 2016 to 2020. The characteristics of SMA infection and influencing factors for respiratory tract and non-respiratory tract SMA infection were retrospectively analyzed, and the result of drug susceptibility testing was observed. RESULTS: A total of 753 case times of patients had SMA infection, including 606 (80.48%) case times of respiratory tract infection and 147 (19.52%) case times of non-respiratory tract infection. The isolation rate was the highest in respiratory medicine department (16.73%), followed by critical care medicine department (15.67%) and neurosurgery department (12.35%). The percentages of the patients with advanced age, complications with hypertension and pulmonary diseases, tracheotomy were the higher in the respiratory tract infection group than in the non-respiratory tract infection group (P < 0.05);while the percentages of the patients with malignant tumors, bacteremia, surgery, urinary tract intubation, low immunity and use of antibiotics and immunosuppressants were the higher in the non-respiratory tract infection group than in the respiratory tract infection group (P < 0.05). The result of drug susceptibility testing showed that the drug resistance rate of the SMA strains to sulfamethoxazole-trimethoprim was only 2.39%, while the drug resistance rate to ceftazidime was as high as 74.50%. CONCLUSION: The major influencing factors for the respiratory tract SMA infection include pulmonary diseases, hypertension, advanced age and tracheotomy;the influencing factors for the non-respiratory tract SMA infection include malignant tumors, low immunity, long-term excessive use of immunosuppressants and broad-spectrum antibiotics, bacteremia, surgery and urinary tract intubation. The SMA strains isolated from the city are highly sensitive to sulfamethoxazole-trimethoprim but are highly resistant to ceftazidime and chloramphenicol. It is necessary for the hospital to reasonably use antibiotics based on the result of drug susceptibility testing.

2.
Laryngoscope Investig Otolaryngol ; 2022 Aug 18.
Article in English | MEDLINE | ID: covidwho-1995548

ABSTRACT

Objectives: To analyze changes in tracheotomy practices at the onset of the COVID-19 pandemic, and determine if quality patient care was maintained. Methods: This was a single institution retrospective study that included patients undergoing tracheotomy from May 2019 to January 2021. Patients were divided into two groups, pre-COVID and post-COVID. Only three patients tested positive for COVID-19, and they were excluded from the study. Data were collected from the electronic medical record. Statistical analyses were performed using 2-tailed independent t tests, Wilcoxon Rank Sum tests, Chi-Square tests, and Kaplan-Meier curves. Results: There were 118 patients in the pre-COVID group and 91 patients in the post-COVID group. The main indication for tracheotomy in both groups was prolonged intubation. There were no significant differences in overall length of stay, time to tracheotomy, duration of tracheotomy procedure, or time to initial tracheotomy change between the two groups. Due to protocols implemented at our institution to limit viral transmission, there were significant increases in the percent of tracheotomies performed in the OR (p = .02), and those performed via open technique (p = .04). Additionally, the median time to decannulation significantly decreased in the post-COVID group (p = .02). Conclusion: Several variables regarding the timing of patient care showed no significant differences between groups which demonstrates that quality patient care was maintained. It is important to note that this data was collected early in the Pandemic, and additional trends may become apparent over time. Level of evidence: 4.

3.
The Journal of Laryngology and Otology ; 136(5):469, 2022.
Article in English | ProQuest Central | ID: covidwho-1991449
4.
Romanian Journal of Rhinology ; 12(47):124-128, 2022.
Article in English | Academic Search Complete | ID: covidwho-1974580

ABSTRACT

OBJECTIVE. To estimate the effect of tracheostomy on ventilation in patients with COVID-19. MATERIAL AND METHODS. An observational, retrospective, analytical, longitudinal study of a consecutive series of cases was carried out between April 2020 and March 2021. The study included data about different variables, such as age, sex, comorbidities, time of orotracheal intubation, place of surgery, complications and death, ventilatory parameters, blood gas and time of the weaning after tracheostomy. Descriptive statistics were used with measures of central tendency, measures of dispersion and the Wilcoxon test to see differences in the ventilatory parameters. RESULTS. The study was performed on 130 patients admitted to the ICU with intubation to manage their critical condition. From these patients, the study group included 31 who underwent tracheostomy, 25 males (80.64%) with a mean age of 57.1±13.395 years and with 20.52±6.722 days in orotracheal intubation. Among the most frequent comorbidities, we encountered: arterial hypertension (51.6%), obesity (35.4%), diabetes mellitus (22.5%), hypothyroidism (6.4%), asthma (3.2%), pregnancy (3.2%), chronic obstructive pulmonary disease (3.2%) and obstructive sleep apnea syndrome (3.2%). The main complications were bleeding (12.9%) and decannulation (3.2%). The survival rate was 90.32%. Comparing the pre-surgical and postoperative outcomes of the ventilatory parameters and blood gas, statistically significant differences were found only in case of PEEP (p = 0.033), FiO2 (p = 0.001) and O2 saturation (p = 0.001). The average removal of the ventilator was 4.3±2.437 days. CONCLUSION. There were no significant changes in the ventilatory parameters, however, they were sufficient to wean the patients from the ventilation team and discharge them to the internal medicine department to continue their management outside the intensive care unit. [ FROM AUTHOR] Copyright of Romanian Journal of Rhinology is the property of Romanian Rhinologic Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

5.
Crit Care ; 26(1): 142, 2022 05 18.
Article in English | MEDLINE | ID: covidwho-1951298

ABSTRACT

BACKGROUND: Critically ill COVID-19 patients may develop acute respiratory distress syndrome and the need for respiratory support, including mechanical ventilation in the intensive care unit. Previous observational studies have suggested early tracheotomy to be advantageous. The aim of this parallel, multicentre, single-blinded, randomized controlled trial was to evaluate the optimal timing of tracheotomy. METHODS: SARS-CoV-2-infected patients within the Region Västra Götaland of Sweden who needed intubation and mechanical respiratory support were included and randomly assigned to early tracheotomy (≤ 7 days after intubation) or late tracheotomy (≥ 10 days after intubation). The primary objective was to compare the total number of mechanical ventilation days between the groups. RESULTS: One hundred fifty patients (mean age 65 years, 79% males) were included. Seventy-two patients were assigned to early tracheotomy, and 78 were assigned to late tracheotomy. One hundred two patients (68%) underwent tracheotomy of whom sixty-one underwent tracheotomy according to the protocol. The overall median number of days in mechanical ventilation was 18 (IQR 9; 28), but no significant difference was found between the two treatment regimens in the intention-to-treat analysis (between-group difference: - 1.5 days (95% CI - 5.7 to 2.8); p = 0.5). A significantly reduced number of mechanical ventilation days was found in the early tracheotomy group during the per-protocol analysis (between-group difference: - 8.0 days (95% CI - 13.8 to - 2.27); p = 0.0064). The overall correlation between the timing of tracheotomy and days of mechanical ventilation was significant (Spearman's correlation: 0.39, p < 0.0001). The total death rate during intensive care was 32.7%, but no significant differences were found between the groups regarding survival, complications or adverse events. CONCLUSIONS: The potential superiority of early tracheotomy when compared to late tracheotomy in critically ill patients with COVID-19 was not confirmed by the present randomized controlled trial but is a strategy that should be considered in selected cases where the need for MV for more than 14 days cannot be ruled out. Trial registration NCT04412356 , registered 05/24/2020.


Subject(s)
COVID-19 , SARS-CoV-2 , Aged , Critical Illness/epidemiology , Critical Illness/therapy , Female , Humans , Male , Respiration, Artificial/methods , Tracheotomy/methods , Treatment Outcome
6.
Am J Otolaryngol ; 43(5): 103525, 2022.
Article in English | MEDLINE | ID: covidwho-1944084

ABSTRACT

OBJECTIVE: To investigate perspectives of patients, family members, caregivers (PFC), and healthcare professionals (HCP) on tracheostomy care during the COVID-19 pandemic. METHODS: The cross-sectional survey investigating barriers and facilitators to tracheostomy care was collaboratively developed by patients, family members, nurses, speech-language pathologists, respiratory care practitioners, physicians, and surgeons. The survey was distributed to the Global Tracheostomy Collaborative's learning community, and responses were analyzed. RESULTS: Survey respondents (n = 191) from 17 countries included individuals with a tracheostomy (85 [45 %]), families/caregivers (43 [22 %]), and diverse HCP (63 [33.0 %]). Overall, 94 % of respondents reported concern that patients with tracheostomy were at increased risk of critical illness from SARS-CoV-2 infection and COVID-19; 93 % reported fear or anxiety. With respect to prioritization of care, 38 % of PFC versus 16 % of HCP reported concern that patients with tracheostomies might not be valued or prioritized (p = 0.002). Respondents also differed in fear of contracting COVID-19 (69 % PFC vs. 49 % HCP group, p = 0.009); concern for hospitalization (55.5 % PFC vs. 27 % HCP, p < 0.001); access to medical personnel (34 % PFC vs. 14 % HCP, p = 0.005); and concern about canceled appointments (62 % PFC vs. 41 % HCP, p = 0.01). Respondents from both groups reported severe stress and fatigue, sleep deprivation, lack of breaks, and lack of support (70 % PFC vs. 65 % HCP, p = 0.54). Virtual telecare seldom met perceived needs. CONCLUSION: PFC with a tracheostomy perceived most risks more acutely than HCP in this global sample. Broad stakeholder engagement is necessary to achieve creative, patient-driven solutions to maintain connection, communication, and access for patients with a tracheostomy.


Subject(s)
Caregivers , Communication , Family , Patients , Postoperative Care/methods , Tracheostomy , COVID-19/complications , COVID-19/epidemiology , Caregivers/psychology , Cross-Sectional Studies , Family/psychology , Fatigue , Humans , Nurses/psychology , Pandemics , Patients/psychology , Physicians/psychology , Postoperative Care/standards , SARS-CoV-2 , Sleep Deprivation , Speech Therapy/psychology , Stress, Psychological , Surgeons/psychology
8.
Anaesthesia and Intensive Care ; 50(1 SUPPL):3-4, 2022.
Article in English | EMBASE | ID: covidwho-1886819

ABSTRACT

Background: Front of Neck Access (FONA) is a critical skill Anaesthetists must be able to perform in the 'Can't Intubate, Can't oxygenate' (CICO) scenario, and is a core technical skill ANZCA registrars must develop during training (ANZCA 2020). However, since the Covid-19 pandemic, opportunities for first hand emergency airway experience have reduced. To gain an understanding of trends in the field of FONA and to guide future advancement, we conducted a bibliometric analysis of the 100 most cited papers for Front of Neck Access. Methods: The Thomas Reuters Web of Science database was searched on 13th of June 2021 using the terms;“Front of Neck Access”, “FONA”, “Cricothyroidotomy”, “Surgical cricothyroidotomy”, “Scalpel Cricothyroidotomy”, “Needle Cricothyroidotomy”. The 100 most cited papers relevant to FONA were analysed by design, topic, author, publication year and institution. The journal impact factor for the year 2019 along with Eigenfactor scores were recorded. Results: A total of 787 papers were retrieved from our search. These were ranked by total number of citations. The median number of citations for the top 100 articles was 56.5 (IQR 28), with 44% of articles originating from the USA. The top five cited papers made up 37% of total citations. Anesthesia (n=9) and The British Journal of Anesthesia (n=9) had the greatest number of papers, whilst the greatest number of citations came from Academic Emergency Medicine (n=2456). The years 2011 (n=9) and 2015 (n=9) had the greatest number of papers published. Technique for emergent FONA was the most common theme. Conclusions: The most influential articles in the FONA literature have each been cited at least 35 times, reflecting considerable impact and quality. The USA has produced most research in this area, allowing the widespread dispersion of indications, technique and guidelines at a time when practical experience may be limited due to the pandemic.

9.
Children ; 9(5):643, 2022.
Article in English | ProQuest Central | ID: covidwho-1870752

ABSTRACT

Enterovirus infection is endemic in many areas, especially in Southeast Asia. Enterovirus infection with severe complications (EVSC) is life-threatening, and timely diagnosis and management are crucial for successful management. Here, we report on a 2-year-old boy with hand, foot, and mouth disease. Myoclonic jerks developed and left abducens nerve palsy followed. Brain magnetic resonance imaging (MRI) showed rhombencephalitis. Pulmonary edema and cardiopulmonary failure developed, and intravenous immunoglobulin and extracorporeal membrane oxygenation were administered. He had a tracheostomy with home ventilator use after 64 days of hospitalization. At a 5-year follow-up, his neurodevelopment was normal with complete recovery from the abducens nerve palsy. The progress of EVSC may be rapid and fulminant, and timely diagnosis is critical for patient prognosis and outcomes. The presence of abducens nerve palsy is an indicator of enteroviral rhombencephalitis, and immediate and appropriate management is suggested.

10.
Int J Surg Case Rep ; 95: 107248, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1867261

ABSTRACT

INTRODUCTION AND IMPORTANCE: Percutaneous dilatational tracheostomy (PDT) has become a routine procedure in intensive care, because of its multiple advantages over surgical tracheostomy (ST). CASE PRESENTATION: We present the case of a 72-year-old patient with SARS-CoV-2 pneumonia, who received a PDT in the 6th tracheal ring with a lateral puncture of the trachea. This atypical placement of tracheostomy was due to a massive left-pronounced goiter, causing a tracheal shift to the right. To avoid dislocation of the tracheal cannula and prevent recurrent bleeding, surgical revision was decided. After left hemithyroidectomy, oral intubation was temporarily necessary, in order to remove the old tracheostomy. Then suturing of the left lateral tracheal defect and standard ST in the 2nd tracheal cartilage was performed. The patient was successfully weaned and decannulated and his swallowing function remained intact. CLINICAL DISCUSSION: In our case left hemithyroidectomy was necessary, in order to enable an optimal surgical tracheostomy in the 2nd tracheal cartilage. Because mechanical ventilation was carried out proximal to the large tracheal defect after PCT, a secondary closing approach was not an option. The endotracheal cuff was placed above the defect, in order to prevent acute or chronic intraluminal pressure trauma. Postoperative x-ray and bronchoscopy insured the sufficient sealing of the tracheal suturing. CONCLUSION: We describe an unusual placement of percutaneous dilatational tracheostomy through a thyroid goiter and our approach to perform a correction surgical tracheostomy.

12.
BMJ Open ; 11(9), 2021.
Article in English | ProQuest Central | ID: covidwho-1842841

ABSTRACT

IntroductionPatients requiring invasive mechanical ventilation via an artificial airway experience sudden voicelessness placing them at risk for adverse outcomes and increasing provider workload. Infection control precautions during the COVID-19 pandemic, including the use of personal protective equipment (eg, gloves, masks, etc), patient isolation, and visitor restrictions may exacerbate communication difficulty. The objective of this study is to evaluate the acceptability of a codesigned communication intervention for use in the adult intensive care unit when infection control precautions such as those used during COVID-19 are required.Methods and analysisThis three-phased, prospective study will take place in a medical surgical ICU in a community teaching hospital in Toronto. Participants will include ICU healthcare providers, adult patients and their family members. Qualitative interviews (target n: 20–25) will explore participant perceptions of the barriers to and facilitators for supporting patient communication in the adult ICU in the context of COVID-19 and infection control precautions (phase 1). Using principles of codesign, a stakeholder advisory council of 8–10 participants will iteratively produce an intervention (phase 2). The codesigned intervention will then be implemented and undergo a mixed method acceptability evaluation in the study setting (phase 3). Acceptability, feasibility and appropriateness will be evaluated using validated measures (target n: 60–65). Follow-up semistructured interviews will be analysed using the theoretical framework of acceptability (TFA). The primary outcomes of this study will be acceptability ratings and descriptions of a codesigned COmmunication intervention for use during and beyond the COVID-19 PandEmic.Ethics and disseminationThe study protocol has been reviewed, and ethics approval was obtained from the Michael Garron Hospital. Results will be made available to healthcare providers in the study setting throughout the study and through publications and conference presentations.

13.
Eur Arch Otorhinolaryngol ; 279(8): 4181-4188, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1844361

ABSTRACT

INTRODUCTION: The coronavirus SARS-CoV-2 pandemic has resulted in a large number of patients requiring intubation and prolonged mechanical ventilation. The current knowledge on the tracheotomies regarding the time form intubation, method and ventilatory parameters optimal for their performance in the mechanically ventilated patients with COVID ARDS are scarce; thus, the aim of this study is to present new data regarding their safety, adverse events and timing. MATERIALS AND METHODS: This retrospective observational study is based on the data of 66 critically ill COVID patients including demographic data, timing and technique of tracheotomy, ventilatory parameters in the time of procedure, as well as complication and survival rate. RESULTS: A number of 66 patients with COVID-related pneumonia were included in the study, among whom 32 were tracheotomized-25 patients underwent an early tracheotomy and 7 patients had late tracheotomy. The median duration of mechanical ventilation before the tracheotomy in the early group was 8 days (IQR 6-10) compared to 11 days (IQR 11-12.5.) p < 0.001) in late group. Risk of death in tracheotomy patients was significantly growing with growing level of PEEP and FiO2 at the moment of decision on tracheotomy, OR = 1.91 CI95 (1.23;3.57); p = 0.014 and OR = 1.18 CI95(1.03;1.43); p = 0.048, respectively. CONCLUSION: Early percutaneous tracheotomy is safe (both in terms of risk of viral transmission and complication rate) and feasible in COVID-19 patients. Stability of gas exchange, and ventilatory parameters are the main prognostic factors of the outcome.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Humans , Intensive Care Units , Respiration, Artificial/adverse effects , SARS-CoV-2 , Tracheotomy/adverse effects
14.
Journal of Clinical & Scientific Research ; 11(2):83-87, 2022.
Article in English | Academic Search Complete | ID: covidwho-1835179

ABSTRACT

Background: Tracheostomy is an important surgical procedure in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) pandemic, particularly those patients undergoing prolonged tracheal intubation. The timing and indications for tracheostomy in COVID-19 patients with ventilators are still controversial. Methods: We prospectively studied the best timing for performing surgical tracheostomy in COVID-19 patients (n = 22) from April 2020 to May 2021 in the COVID-19 ICU attached to our COVID-19 hospital. The tracheotomised patients were followed up and the number and timing of the death were documented. Results: There were 14 males (male:female = 1.75:1). The mean duration of endotracheal intubation to tracheostomy was 14.4 days (range 10-22 days). The mean time for tracheostomy was 18.45 min (range 12-25 min). Five patients (22.7%) died after tracheostomy. The median time between tracheostomy and death was 4 days. Conclusions: Surgical tracheostomy has to be performed in a proper time with safe manner for benefit of the patients with COVID-19 and the health care professionals managing the patient. [ FROM AUTHOR] Copyright of Journal of Clinical & Scientific Research is the property of Sri Venkateswara Institute of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

15.
Aerosol and Air Quality Research ; 20(12), 2020.
Article in English | ProQuest Central | ID: covidwho-1771374

ABSTRACT

Background: During mechanical ventilation of a patient requiring ventilatory support, bystanders could potentially be exposed to aerosolised drug. Methods: Fugitive drug aerosol emissions during simulated adult mechanical ventilation was assessed on a dual limb circuit. Tidal volume was set at 270 mL and 820 mL. The use of a protective filter on the exhalation port of the mechanical ventilator was assessed. Results: Higher fugitive aerosol mass concentrations in the local environment were associated with larger tidal volume (0.077 (0.073, 0.091) mg m–3 at Vt = 820 mL vs. 0.062 (0.056, 0.065) mg m–3 at Vt = 270 mL) when no protective filter was used. The range of mass median aerodynamic diameters recorded was from 0.93 to 2.96 µm. When a filter was placed on the exhalation port of the mechanical ventilator, no fugitive emissions were recorded. Conclusion: This study confirms that an appropriate filtration protocol mitigates the risk of fugitive emissions being released when patients undergo aerosol therapy during mechanical ventilation. A larger tidal volume resulted in higher fugitive aerosol mass.

16.
International Journal of Therapy and Rehabilitation ; 29(2):1-13, 2022.
Article in English | ProQuest Central | ID: covidwho-1732496

ABSTRACT

Background/Aims Patients treated with intubation and tracheostomy for COVID-19 infection are at risk of increased incidence of laryngeal injury, dysphagia and dysphonia. Because of the novelty of the SARS-CoV-2 virus, little is known about the type of dysphagia patients experience as a result of infection and critical illness. The aim of this case series report was to progress understanding of COVID-19 and dysphagia following admission to an intensive care unit and to guide speech and language therapy clinical practice in the ongoing pandemic. Methods A retrospective case review was conducted of all patients at Imperial College Healthcare NHS Trust, London who underwent a tracheostomy because of COVID-19 and received an instrumental assessment of swallowing in the early stages of the pandemic. Results A total of 11 patients were identified, and descriptive statistics were used to present demographic data, with a narrative account of their dysphagia profile used to describe presentation. Causes and presentation of dysphagia were heterogenous, with each patient requiring individualised clinical management to maximise outcome. A positive trend was seen in terms of recovery trajectory and progressing to oral intake. Conclusions This study reports on early experience of the presentation of dysphagia in patients with COVID-19 and demonstrates the value of instrumental assessment. It indicates the need for further research to consolidate knowledge and guide clinical practice.

17.
Pakistan Armed Forces Medical Journal ; 71(5):1713, 2021.
Article in English | ProQuest Central | ID: covidwho-1728371

ABSTRACT

Objective: To share our experience of tracheostomy in COVID-19 positive patients. Study Design: Prospective observational study. Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi Pakistan, from Apr to Jul 2020. Methodology: A total of 94 COVID-19 positive cases admitted to the Intensive Care Unit of this hospital, placed on ventilatory support and who ultimately underwent tracheostomy (whether percutaneous or surgical) were included in the study. Patients were included irrespective of any age group or gender. Results: Out of 94 patients placed on ventilator, tracheostomy was performed only in 17 patients. Male predominance was 13 (76%), with mean age of patients as 55.59 ± 12.93 in 12 patients, surgical tracheostomy was performed (70.58%) whereas in 5 (29.4%) cases percutaneous tracheostomy was done. On post-operative follow-up 8 out of 17 (47%) patients recovered and were successfully decannulated whereas 9 (52.9%) patients could not survive. Tracheostomy was successfully performed as early as 8th day of mechanical ventilator support. Health Care Workers (HCWs) involved were subjected to RT-PCR and remained negative for SARSCoV-2. There was statistically significant association between the type and indication of tracheostomy, p=0.002. Conclusion: Tracheostomy, in COVID-19 positive patients, being aerosolgenerating procedure remains a medical hazard for the HCWs. By following strict safety protocols according to the medical resources available and training of the HCWs, it can be performed with complete safety. It can be done as early as 8th day of ventilator support.

18.
Rev Esp Anestesiol Reanim (Engl Ed) ; 69(2): 105-108, 2022 02.
Article in English | MEDLINE | ID: covidwho-1707579

ABSTRACT

Vocal cord paralysis is a rare but severe complication after orotracheal intubation. The most common cause is traumatic, due to compression of the recurrent laryngeal nerve between the orotracheal tube cuff and the thyroid cartilage. Other possible causes are direct damage to the vocal cords during intubation, dislocation of the arytenoid cartilages, or infections, especially viral infections. It is usually due to a recurrent laryngeal nerve neuropraxia, and the course is benign in most patients. We present the case of a man who developed late bilateral vocal cord paralysis after pneumonia complicated with respiratory distress due to SARS-CoV-2 that required orotracheal intubation for 11 days. He presented symptoms of dyspnea 20 days after discharge from hospital with subsequent development of stridor, requiring a tracheostomy. Due to the temporal evolution, a possible contribution of the SARS-CoV-2 infection to the picture is pointed out.


Subject(s)
COVID-19 , Vocal Cord Paralysis , COVID-19/complications , Humans , Intubation, Intratracheal/adverse effects , Male , SARS-CoV-2 , Tracheostomy/adverse effects , Vocal Cord Paralysis/etiology
19.
The International Student Journal of Nurse Anesthesia ; 20(2):18-21, 2021.
Article in English | ProQuest Central | ID: covidwho-1695518

ABSTRACT

Keywords: tracheotomy, COVID-19, aerosol-generating procedures, precautions, transmission The novel coronavirus disease 2019 (COVID-19) outbreak, caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout the world and has been declared a pandemic by the World Health Organization.1 SARS-CoV-2 remains viable in aerosols for up to 3 hours, leading to the recommendation to avoid aerosol-generating procedures (AGPs), such as tracheotomy, in patients with COVID-19.1,2 However, in patients with head and neck cancers that cause airway obstruction, a tracheotomy may be necessary. The procedure took place in a negative pressure operating room with donning of appropriate personal protective equipment (PPE): N95 respirator mask, gloves, goggles or a face shield, and a surgical cap. When participating in AGPs, personnel should wear a gown, gloves, eye protection (goggles or a disposable face shield that covers the front and sides of the face), and airway protection with N95 masks or powered air-purifying respirators (PAPRs)7 It is essential to perform proper hand hygiene before putting on and after removing PPE. Disposable materials should be discarded at the end of the case, and the room subjected to a terminal clean.4,5,7 A HEPA filter should be placed between the Y-piece of the breathing circuit and the patient's mask or tracheal tube.7 A HEPA filter should also protect the gas sampling tubing, and gases exiting the gas analyzer should be scavenged and not returned to 7 room air All traffic in and out of the OR should be minimized.4,5,7 Support staff should be dedicated to the OR to provide all materials needed throughout the case, with exchanges performed using a material exchange cart placed immediately outside the room or in the anteroom. 4,5,7 All recommended precautions were followed during this case, except for determining the patient's infection status preoperatively.

20.
Erciyes Medical Journal ; 44(1):77-81, 2022.
Article in English | CAB Abstracts | ID: covidwho-1631470

ABSTRACT

Objective: During the COVID-19 pandemic, many patients require intensive care unit (ICU) hospitalization with mechanical ventilation (MV). There is still no clear information about the timing and indications of tracheostomy in COVID-19 cases. We aimed to evaluate the relationship between the timing of tracheostomy and outcomes of critical COVID-19 cases. Materials and Methods: This single-center, retrospective, observational study included patients with COVID-19 who were intubated in the ICU between November 1, 2020 and February 1, 2021, and underwent percutaneous tracheostomy. Demographic data of all patients, the day each patient underwent a percutaneous tracheostomy, the complications related to the procedure, laboratory data, mortality, MV duration, and ICU length of stay (LOS) were recorded.

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