Your browser doesn't support javascript.
Percutaneous Dilational Tracheostomy for Coronavirus Disease 2019 Patients Requiring Mechanical Ventilation.
Angel, Luis F; Amoroso, Nancy E; Rafeq, Samaan; Mitzman, Brian; Goldenberg, Ronald; Shekar, Saketh Palasamudram; Troxel, Andrea B; Zhang, Yan; Chang, Stephanie H; Kwak, Paul; Amin, Milan R; Sureau, Kimberly; Nafday, Heidi B; Thomas, Sarun; Kon, Zachary; Sommer, Philip M; Segal, Leopoldo N; Moore, William H; Cerfolio, Robert.
  • Angel LF; Division of Pulmonary and Critical Care, Department of Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Amoroso NE; Department of Cardiothoracic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Rafeq S; Division of Pulmonary and Critical Care, Department of Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Mitzman B; Division of Pulmonary and Critical Care, Department of Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Goldenberg R; Department of Cardiothoracic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Shekar SP; Division of Pulmonary and Critical Care, Department of Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Troxel AB; Division of Pulmonary and Critical Care, Department of Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Zhang Y; Division of Biostatistics, Department of Population Health, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Chang SH; Division of Biostatistics, Department of Population Health, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Kwak P; Department of Cardiothoracic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Amin MR; Division of Ear Nose and Throat, Department of Otorhinolaryngology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Sureau K; Division of Ear Nose and Throat, Department of Otorhinolaryngology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Nafday HB; Department of Cardiothoracic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Thomas S; Department of Cardiothoracic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Kon Z; Division of Pulmonary and Critical Care, Department of Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Sommer PM; Department of Cardiothoracic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Segal LN; Division of Critical Care Anesthesia, Department of Anesthesia, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Moore WH; Division of Pulmonary and Critical Care, Department of Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
  • Cerfolio R; Division of Thoracic Radiology, Department of Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY.
Crit Care Med ; 49(7): 1058-1067, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1494030
Semantic information from SemMedBD (by NLM)
1. Percutaneous dilational tracheostomy TREATS COVID-19
Subject
Percutaneous dilational tracheostomy
Predicate
TREATS
Object
COVID-19
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Percutaneous dilational tracheostomy TREATS Patients
Subject
Percutaneous dilational tracheostomy
Predicate
TREATS
Object
Patients
4. Respiratory Failure PROCESS_OF Patients
Subject
Respiratory Failure
Predicate
PROCESS_OF
Object
Patients
5. High probability PROCESS_OF Patients
Subject
High probability
Predicate
PROCESS_OF
Object
Patients
6. Tracheostomy procedure compared_with Percutaneous dilational tracheostomy
Subject
Tracheostomy procedure
Predicate
compared_with
Object
Percutaneous dilational tracheostomy
7. Discontinued PROCESS_OF Patients
Subject
Discontinued
Predicate
PROCESS_OF
Object
Patients
8. Discontinued PROCESS_OF Survivors
Subject
Discontinued
Predicate
PROCESS_OF
Object
Survivors
9. Percutaneous dilational tracheostomy compared_with Percutaneous dilational tracheostomy
Subject
Percutaneous dilational tracheostomy
Predicate
compared_with
Object
Percutaneous dilational tracheostomy
10. Symptoms PROCESS_OF Health Personnel
Subject
Symptoms
Predicate
PROCESS_OF
Object
Health Personnel
11. Percutaneous dilational tracheostomy TREATS COVID-19
Subject
Percutaneous dilational tracheostomy
Predicate
TREATS
Object
COVID-19
12. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
13. Percutaneous dilational tracheostomy TREATS Patients
Subject
Percutaneous dilational tracheostomy
Predicate
TREATS
Object
Patients
14. Respiratory Failure PROCESS_OF Patients
Subject
Respiratory Failure
Predicate
PROCESS_OF
Object
Patients
15. High probability PROCESS_OF Patients
Subject
High probability
Predicate
PROCESS_OF
Object
Patients
16. Tracheostomy procedure compared_with Percutaneous dilational tracheostomy
Subject
Tracheostomy procedure
Predicate
compared_with
Object
Percutaneous dilational tracheostomy
17. Discontinued PROCESS_OF Patients
Subject
Discontinued
Predicate
PROCESS_OF
Object
Patients
18. Discontinued PROCESS_OF Survivors
Subject
Discontinued
Predicate
PROCESS_OF
Object
Survivors
19. Percutaneous dilational tracheostomy compared_with Percutaneous dilational tracheostomy
Subject
Percutaneous dilational tracheostomy
Predicate
compared_with
Object
Percutaneous dilational tracheostomy
20. Symptoms PROCESS_OF Health Personnel
Subject
Symptoms
Predicate
PROCESS_OF
Object
Health Personnel
ABSTRACT

OBJECTIVES:

To assess the impact of percutaneous dilational tracheostomy in coronavirus disease 2019 patients requiring mechanical ventilation and the risk for healthcare providers.

DESIGN:

Prospective cohort study; patients were enrolled between March 11, and April 29, 2020. The date of final follow-up was July 30, 2020. We used a propensity score matching approach to compare outcomes. Study outcomes were formulated before data collection and analysis.

SETTING:

Critical care units at two large metropolitan hospitals in New York City. PATIENTS Five-hundred forty-one patients with confirmed severe coronavirus disease 2019 respiratory failure requiring mechanical ventilation.

INTERVENTIONS:

Bedside percutaneous dilational tracheostomy with modified visualization and ventilation. MEASUREMENTS AND MAIN

RESULTS:

Required time for discontinuation off mechanical ventilation, total length of hospitalization, and overall patient survival. Of the 541 patients, 394 patients were eligible for a tracheostomy. One-hundred sixteen were early percutaneous dilational tracheostomies with median time of 9 days after initiation of mechanical ventilation (interquartile range, 7-12 d), whereas 89 were late percutaneous dilational tracheostomies with a median time of 19 days after initiation of mechanical ventilation (interquartile range, 16-24 d). Compared with patients with no tracheostomy, patients with an early percutaneous dilational tracheostomy had a higher probability of discontinuation from mechanical ventilation (absolute difference, 30%; p < 0.001; hazard ratio for successful discontinuation, 2.8; 95% CI, 1.34-5.84; p = 0.006) and a lower mortality (absolute difference, 34%, p < 0.001; hazard ratio for death, 0.11; 95% CI, 0.06-0.22; p < 0.001). Compared with patients with late percutaneous dilational tracheostomy, patients with early percutaneous dilational tracheostomy had higher discontinuation rates from mechanical ventilation (absolute difference 7%; p < 0.35; hazard ratio for successful discontinuation, 1.53; 95% CI, 1.01-2.3; p = 0.04) and had a shorter median duration of mechanical ventilation in survivors (absolute difference, -15 d; p < 0.001). None of the healthcare providers who performed all the percutaneous dilational tracheostomies procedures had clinical symptoms or any positive laboratory test for severe acute respiratory syndrome coronavirus 2 infection.

CONCLUSIONS:

In coronavirus disease 2019 patients on mechanical ventilation, an early modified percutaneous dilational tracheostomy was safe for patients and healthcare providers and associated with improved clinical outcomes.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiration, Artificial / Tracheostomy / COVID-19 Type of study: Etiology study / Incidence study / Observational study / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Crit Care Med Year: 2021 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiration, Artificial / Tracheostomy / COVID-19 Type of study: Etiology study / Incidence study / Observational study / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Crit Care Med Year: 2021 Document Type: Article