Your browser doesn't support javascript.
Tracheostomy for COVID-19 Respiratory Failure: Multidisciplinary, Multicenter Data on Timing, Technique, and Outcomes.
Mahmood, Kamran; Cheng, George Z; Van Nostrand, Keriann; Shojaee, Samira; Wayne, Max T; Abbott, Matthew; Nettlow, Darrell; Parish, Alice; Green, Cynthia L; Safi, Javeryah; Brenner, Michael J; De Cardenas, Jose.
  • Mahmood K; Department of Medicine, Division of Pulmonary, Allergy and Critical Care, Duke University, Durham, NC.
  • Cheng GZ; Department of Medicine, Division of Pulmonary and Critical Care, University of California, San Diego, CA.
  • Van Nostrand K; Department of Medicine, Division of Pulmonary and Critical Care, Emory University, Atlanta, GA.
  • Shojaee S; Department of Medicine, Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, VA.
  • Wayne MT; Department of Medicine, Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI.
  • Abbott M; Department of Medicine, Division of Pulmonary, Allergy and Critical Care, Duke University, Durham, NC.
  • Nettlow D; Department of Medicine, Division of Pulmonary and Critical Care, University of California, San Diego, CA.
  • Parish A; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC.
  • Green CL; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC.
  • Safi J; Department of Medicine, Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, VA.
  • Brenner MJ; Department of Otolaryngology- Head and Neck Surgery, University of Michigan, Ann Arbor, MI.
  • De Cardenas J; Global Tracheostomy Collaborative, Raleigh, NC.
Ann Surg ; 274(2): 234-239, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1304022
Semantic information from SemMedBD (by NLM)
1. Tracheostomy procedure TREATS COVID-19
Subject
Tracheostomy procedure
Predicate
TREATS
Object
COVID-19
2. Tracheostomy procedure TREATS Respiratory Failure
Subject
Tracheostomy procedure
Predicate
TREATS
Object
Respiratory Failure
3. Respiratory Failure PROCESS_OF Patients
Subject
Respiratory Failure
Predicate
PROCESS_OF
Object
Patients
4. Tracheostomy procedure TREATS Patients
Subject
Tracheostomy procedure
Predicate
TREATS
Object
Patients
5. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
6. Respiratory Failure AFFECTS Patients
Subject
Respiratory Failure
Predicate
AFFECTS
Object
Patients
7. Hospitals LOCATION_OF Retrospective Studies
Subject
Hospitals
Predicate
LOCATION_OF
Object
Retrospective Studies
8. Tracheostomy procedure ADMINISTERED_TO Patients
Subject
Tracheostomy procedure
Predicate
ADMINISTERED_TO
Object
Patients
9. Percutaneous techniques METHOD_OF Tracheostomy procedure
Subject
Percutaneous techniques
Predicate
METHOD_OF
Object
Tracheostomy procedure
10. Percutaneous tracheostomy compared_with Exteriorization of trachea
Subject
Percutaneous tracheostomy
Predicate
compared_with
Object
Exteriorization of trachea
11. Tracheostomy procedure TREATS COVID-19
Subject
Tracheostomy procedure
Predicate
TREATS
Object
COVID-19
12. Tracheostomy procedure TREATS Respiratory Failure
Subject
Tracheostomy procedure
Predicate
TREATS
Object
Respiratory Failure
13. Respiratory Failure PROCESS_OF Patients
Subject
Respiratory Failure
Predicate
PROCESS_OF
Object
Patients
14. Tracheostomy procedure TREATS Patients
Subject
Tracheostomy procedure
Predicate
TREATS
Object
Patients
15. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
16. Respiratory Failure AFFECTS Patients
Subject
Respiratory Failure
Predicate
AFFECTS
Object
Patients
17. Hospitals LOCATION_OF Retrospective Studies
Subject
Hospitals
Predicate
LOCATION_OF
Object
Retrospective Studies
18. Tracheostomy procedure ADMINISTERED_TO Patients
Subject
Tracheostomy procedure
Predicate
ADMINISTERED_TO
Object
Patients
19. Percutaneous techniques METHOD_OF Tracheostomy procedure
Subject
Percutaneous techniques
Predicate
METHOD_OF
Object
Tracheostomy procedure
20. Percutaneous tracheostomy compared_with Exteriorization of trachea
Subject
Percutaneous tracheostomy
Predicate
compared_with
Object
Exteriorization of trachea
ABSTRACT

OBJECTIVE:

The aim of this study was to assess the outcomes of tracheostomy in patients with COVID-19 respiratory failure. SUMMARY BACKGROUND DATA Tracheostomy has an essential role in managing COVID-19 patients with respiratory failure who require prolonged mechanical ventilation. However, limited data are available on how tracheostomy affects COVID-19 outcomes, and uncertainty surrounding risk of infectious transmission has led to divergent recommendations and practices.

METHODS:

It is a multicenter, retrospective study; data were collected on all tracheostomies performed in COVID-19 patients at 7 hospitals in 5 tertiary academic medical systems from February 1, 2020 to September 4, 2020.

RESULT:

Tracheotomy was performed in 118 patients with median time from intubation to tracheostomy of 22 days (Q1-Q3 18-25). All tracheostomies were performed employing measures to minimize aerosol generation, 78.0% by percutaneous technique, and 95.8% at bedside in negative pressure rooms. Seventy-eight (66.1%) patients were weaned from the ventilator and 18 (15.3%) patients died from causes unrelated to tracheostomy. No major procedural complications occurred. Early tracheostomy (≤14 days) was associated with decreased ventilator days; median ventilator days (Q1-Q3) among patients weaned from the ventilator in the early, middle and late groups were 21 (21-31), 34 (26.5-42), and 37 (32-41) days, respectively with P = 0.030. Compared to surgical tracheostomy, percutaneous technique was associated with faster weaning for patients weaned off the ventilator [median (Q1-Q3) 34 (29-39) vs 39 (34-51) days, P = 0.038]; decreased ventilator-associated pneumonia (58.7% vs 80.8%, P = 0.039); and among patients who were discharged, shorter intensive care unit duration [median (Q1-Q3) 33 (27-42) vs 47 (33-64) days, P = 0.009]; and shorter hospital length of stay [median (Q1-Q3) 46 (33-59) vs 59.5 (48-80) days, P = 0.001].

CONCLUSION:

Early, percutaneous tracheostomy was associated with improved outcomes compared to surgical tracheostomy in a multi-institutional series of ventilated patients with COVID-19.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiration, Artificial / Respiratory Insufficiency / Tracheostomy / COVID-19 Type of study: Controlled clinical trial / Clinical Practice Guide / Observational study / Randomized controlled trials / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Ann Surg Year: 2021 Document Type: Article Affiliation country: SLA.0000000000004955

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiration, Artificial / Respiratory Insufficiency / Tracheostomy / COVID-19 Type of study: Controlled clinical trial / Clinical Practice Guide / Observational study / Randomized controlled trials / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Ann Surg Year: 2021 Document Type: Article Affiliation country: SLA.0000000000004955