Tracheotomy in COVID-19 patients: Optimizing patient selection and identifying prognostic indicators.
Head Neck
; 42(7): 1386-1391, 2020 Jul.
Article
in English
| MEDLINE | ID: covidwho-342843
ABSTRACT
BACKGROUND:
Tracheotomy, through its ability to wean patients off ventilation, can shorten ICU length of stay and in doing so increase ICU bed capacity, crucial for saving lives during the COVID-19 pandemic. To date, there is a paucity of patient selection criteria and prognosticators to facilitate decision making and enhance precious ICU capacity.METHODS:
Prospective study of COVID-19 patients undergoing tracheotomy (n = 12) over a 4-week period (March-April 2020). Association between preoperative and postoperative ventilation requirements and outcomes (ICU stay, time to decannulation, and death) were examined.RESULTS:
Patients who sustained FiO2 ≤ 50% and PEEP ≤ 8 cm H2 O in the 24 hours pretracheotomy exhibited a favorable outcome. Those whose requirements remained below these thresholds post-tracheotomy could be safely stepped down after 48 hours.CONCLUSION:
Sustained FiO2 ≤ 50% and PEEP ≤ 8 cm H2 O in the 48 hours post-tracheotomy are strong predictive factors for a good outcome, raising the potential for these patients to be stepped down early, thus increasing ICU capacity.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Respiration, Artificial
/
Tracheotomy
/
Coronavirus Infections
/
Pandemics
/
Intensive Care Units
/
Length of Stay
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
English
Journal:
Head Neck
Journal subject:
Neoplasms
Year:
2020
Document Type:
Article
Affiliation country:
Hed.26280
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