ICU tracheotomies in patients with COVID-19: a lesson learned for future viral pandemic.
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 ANDMETHODS:
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.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pandemics
/
COVID-19
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Eur Arch Otorhinolaryngol
Journal subject:
Otolaryngology
Year:
2022
Document Type:
Article
Affiliation country:
S00405-022-07360-4
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