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Tracheostomy is Safe in Patients with Prolonged Intubation After Coronavirus Disease 2019 Infection.
Goldstein, Carma; Deisher, David; Gorman, Elizabeth; Sheikh, Fariha; Sifri, Ziad; Glass, Nina E.
  • Goldstein C; Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
  • Deisher D; Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
  • Gorman E; Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
  • Sheikh F; Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
  • Sifri Z; Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
  • Glass NE; Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey. Electronic address: nina.glass@rutgers.edu.
J Surg Res ; 266: 361-365, 2021 10.
Article in English | MEDLINE | ID: covidwho-1275539
ABSTRACT

BACKGROUND:

Tracheostomy improves outcomes for critically ill patients requiring prolonged mechanical ventilation. Data are limited on the use and benefit of tracheostomies for intubated, critically ill coronavirus disease 2019 (COVID-19) patients. During the surge in COVID 19 infections in metropolitan New York/New Jersey, our hospital cared for many COVID-19 patients who required prolonged intubation. This study describes the outcomes in COVID-19 patients who underwent tracheostomy.

METHODS:

We present a case series of patients with COVID-19 who underwent tracheostomy at a single institution. Tracheostomies were performed on patients with prolonged mechanical ventilation beyond 3 wk. Patient demographics, medical comorbidities, and ventilator settings prior to tracheostomy were reviewed. Primary outcome was in-hospital mortality. Secondary outcomes included time on mechanical ventilation, length of ICU and hospital stay, and discharge disposition.

RESULTS:

Fifteen COVID-19 patients underwent tracheostomy at an average of 31 d post intubation. Two patients (13%) died. Half of our cohort was liberated from the ventilator (8 patients, 53%), with an average time to liberation of 14 ± 6 d after tracheostomy. Among patients off mechanical ventilation, 5 (63%) had their tracheostomies removed prior to discharge. The average intensive care length of stay was 47 ± 13 d (range 29-74 d) and the average hospital stay was 59 ± 16 d (range 34-103 d).

CONCLUSIONS:

This study reports promising outcomes in COVID-19 patients with acute respiratory failure and need for prolonged ventilation who undergo tracheostomy during their hospitalization. Further research is warranted to establish appropriate indications for tracheostomy in COVID-19 and confirm outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiration, Artificial / Respiratory Insufficiency / Tracheostomy / COVID-19 / Intubation, Intratracheal Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Male / Middle aged Language: English Journal: J Surg Res Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiration, Artificial / Respiratory Insufficiency / Tracheostomy / COVID-19 / Intubation, Intratracheal Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Male / Middle aged Language: English Journal: J Surg Res Year: 2021 Document Type: Article