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Percutaneous Tracheostomy in Respiratory Failure Due to COVID-19.
Cohen, Samuel E; Lopez, Angelena R; Ng, Philip K; Friedman, Oren A; Chaux, George E.
  • Cohen SE; Department of Pulmonary and Critical Care Medicine.
  • Lopez AR; Procedure Center, Cedars-Sinai Medical Center, Los Angeles, CA.
  • Ng PK; Department of Pulmonary and Critical Care Medicine.
  • Friedman OA; Procedure Center, Cedars-Sinai Medical Center, Los Angeles, CA.
  • Chaux GE; Department of Pulmonary and Critical Care Medicine.
J Bronchology Interv Pulmonol ; 29(2): 125-130, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-2307958
ABSTRACT

BACKGROUND:

Coronavirus disease 2019 (COVID-19) can lead to hypoxemic respiratory failure resulting in prolonged mechanical ventilation. Typically, tracheostomy is considered in patients who remain ventilator dependent beyond 2 weeks. However, in the setting of this novel respiratory virus, the safety and benefits of tracheostomy are not well-defined. Our aim is to describe our experience with percutaneous tracheostomy in patients with COVID-19. MATERIALS AND

METHODS:

This is a single center retrospective descriptive study. We reviewed comorbidities and outcomes in patients with respiratory failure due to COVID-19 who underwent percutaneous tracheostomy at our institution from April 2020 to September 2020. In addition, we provide details of our attempt to minimize aerosolization by using a modified protocol with brief periods of planned apnea.

RESULTS:

A total of 24 patients underwent percutaneous tracheostomy during the study. The average body mass index was 33.0±10.0. At 30 days posttracheostomy 17 (71%) patients still had the tracheostomy tube and 14 (58%) remained ventilator dependent. There were 3 (13%) who died within 30 days. At the time of data analysis in November 2020, 9 (38%) patients had died and 7 (29%) had been decannulated. None of the providers who participated in the procedure experienced signs or symptoms of COVID-19 infection.

CONCLUSION:

Percutaneous tracheostomy in prolonged respiratory failure due to COVID-19 appears to be safe to perform at the bedside for both the patient and health care providers in the appropriate clinical context. Morbid obesity did not limit the ability to perform percutaneous tracheostomy in COVID-19 patients.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Insufficiency / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Bronchology Interv Pulmonol Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Insufficiency / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Bronchology Interv Pulmonol Year: 2022 Document Type: Article