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Indications and timing for tracheostomy in patients with SARS CoV2-related.
Ferri, Emanuele; Boscolo Nata, Francesca; Pedruzzi, Barbara; Campolieti, Giovanni; Scotto di Clemente, Francesco; Baratto, Fabio; Cristalli, Giovanni.
  • Ferri E; Otorhinolaryngology Unit, Ospedali Riuniti Padova Sud "Madre Teresa Di Calcutta" Hub Covid Hospital Monselice (Padova)-ULSS 6 Euganea, Padua, Italy. emanuele.ferri@aulss6.veneto.it.
  • Boscolo Nata F; Otorhinolaryngology Unit, Ospedali Riuniti Padova Sud "Madre Teresa Di Calcutta" Hub Covid Hospital Monselice (Padova)-ULSS 6 Euganea, Padua, Italy.
  • Pedruzzi B; Otorhinolaryngology Unit, Ospedali Riuniti Padova Sud "Madre Teresa Di Calcutta" Hub Covid Hospital Monselice (Padova)-ULSS 6 Euganea, Padua, Italy.
  • Campolieti G; Otorhinolaryngology Unit, Ospedali Riuniti Padova Sud "Madre Teresa Di Calcutta" Hub Covid Hospital Monselice (Padova)-ULSS 6 Euganea, Padua, Italy.
  • Scotto di Clemente F; Otorhinolaryngology Unit, Ospedali Riuniti Padova Sud "Madre Teresa Di Calcutta" Hub Covid Hospital Monselice (Padova)-ULSS 6 Euganea, Padua, Italy.
  • Baratto F; Anaesthesia and Intensive Care Unit, Ospedali Riuniti Padova Sud "Madre Teresa Di Calcutta" Hub Covid Hospital Monselice (Padova)-ULSS 6 Euganea, Padua, Italy.
  • Cristalli G; Otorhinolaryngology Unit, Ospedali Riuniti Padova Sud "Madre Teresa Di Calcutta" Hub Covid Hospital Monselice (Padova)-ULSS 6 Euganea, Padua, Italy.
Eur Arch Otorhinolaryngol ; 277(8): 2403-2404, 2020 08.
Article in English | MEDLINE | ID: covidwho-378190
Semantic information from SemMedBD (by NLM)
1. Tracheostomy procedure TREATS Patients
Subject
Tracheostomy procedure
Predicate
TREATS
Object
Patients
2. Trachea LOCATION_OF Tissue damage
Subject
Trachea
Predicate
LOCATION_OF
Object
Tissue damage
3. Problem PROCESS_OF Patients
Subject
Problem
Predicate
PROCESS_OF
Object
Patients
4. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
5. Disease PREDISPOSES Possible
Subject
Disease
Predicate
PREDISPOSES
Object
Possible
6. Tracheostomy procedure TREATS COVID-19
Subject
Tracheostomy procedure
Predicate
TREATS
Object
COVID-19
7. Orotracheal intubation PRECEDES Tracheostomy procedure
Subject
Orotracheal intubation
Predicate
PRECEDES
Object
Tracheostomy procedure
8. Tracheostomy procedure TREATS Patients
Subject
Tracheostomy procedure
Predicate
TREATS
Object
Patients
9. Trachea LOCATION_OF Tissue damage
Subject
Trachea
Predicate
LOCATION_OF
Object
Tissue damage
10. Problem PROCESS_OF Patients
Subject
Problem
Predicate
PROCESS_OF
Object
Patients
11. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
12. Disease PREDISPOSES Possible
Subject
Disease
Predicate
PREDISPOSES
Object
Possible
13. Tracheostomy procedure TREATS COVID-19
Subject
Tracheostomy procedure
Predicate
TREATS
Object
COVID-19
14. Orotracheal intubation PRECEDES Tracheostomy procedure
Subject
Orotracheal intubation
Predicate
PRECEDES
Object
Tracheostomy procedure
ABSTRACT

BACKGROUND:

The indications and timing for tracheostomy in patients with SARS CoV2-related are controversial.

PURPOSE:

In a recent issue published in the European Archives of Otorhinolaryngology, Mattioli et al. published a short communication about tracheostomy timing in patients with COVID-19 (Coronavirus Disease 2019); they reported that the tracheostomy could allow early Intensive Care Units discharge and, in the context of prolonged Invasive Mechanical Ventilation, should be suggested within 7 and 14 days to avoid potential tracheal damages. In this Letter to the Editor we would like to present our experience with tracheostomy in a Hub Covid Hospital.

METHODS:

8 patients underwent open tracheostomy in case of intubation prolonged over 14 days, bronchopulmonary overlap infections, and patients undergoing weaning. They were followed up and the number and timing of death were recorded.

RESULTS:

Two patients died after tracheostomy; the median time between tracheostomy and death was 3 days. A negative prognostic trend was observed for a shorter duration of intubation.

CONCLUSION:

In our experience, tracheostomy does not seem to influence the clinical course and prognosis of the disease, in the face of possible risks of contagion for healthcare workers. The indication for tracheostomy in COVID-19 patients should be carefully evaluated and reserved for selected patients. Although it is not possible to define an optimal timing, it is our opinion that tracheostomy in a stable or clinically improved COVID-19 patient should not be proposed before the 20th day after orotracheal intubation.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiration, Artificial / Tracheostomy / Coronavirus Infections / Minimally Invasive Surgical Procedures / Critical Care / Intubation, Intratracheal Type of study: Prognostic study Limits: Female / Humans / Male / Middle aged Language: English Journal: Eur Arch Otorhinolaryngol Journal subject: Otolaryngology Year: 2020 Document Type: Article Affiliation country: S00405-020-06068-7

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiration, Artificial / Tracheostomy / Coronavirus Infections / Minimally Invasive Surgical Procedures / Critical Care / Intubation, Intratracheal Type of study: Prognostic study Limits: Female / Humans / Male / Middle aged Language: English Journal: Eur Arch Otorhinolaryngol Journal subject: Otolaryngology Year: 2020 Document Type: Article Affiliation country: S00405-020-06068-7