RESUMEN
During the COVID-19 pandemic, percutaneous tracheostomy proved to be an effective option in the management of patients with prolonged periods of intubation. In fact, among other things, it allowed early discharge from ICUs and contributed to reducing overcrowding in intensive care settings, a central and critical point in the COVID pandemic. As a direct consequence, the management and the weaning of frail, tracheostomized and ventilated patients was diverted to sub-intensive or normal hospitalization wards. One central challenge in this setting is the resumption of swallowing and oral feeding, which require interdisciplinary management involving a phoniatrician, ENT, pneumologist, and speech therapist. With this article, we aim to share the experience of a Swiss COVID-19 Center and to draw up a narrative review on the issues concerning the management of the tracheostomy cannula during swallowing resumption, integrating the most recent evidence from the literature with the clinical experiences of the professionals directly involved in the management of tracheostomized COVID-19 patients. In view of the heterogeneity of COVID-19 patients, we believe that the procedures described in the article are applicable to a larger population of patients undergoing tracheostomy weaning.
Asunto(s)
COVID-19 , Deglución , Humanos , Pandemias , Suiza , Traqueostomía/métodosAsunto(s)
COVID-19/complicaciones , Síndrome de Dificultad Respiratoria/etiología , Síndrome de Dificultad Respiratoria/terapia , Desconexión del Ventilador/métodos , Manejo de la Vía Aérea/métodos , Métodos de Alimentación , Humanos , Pandemias , Síndrome de Dificultad Respiratoria/rehabilitación , SARS-CoV-2 , Suiza , Traqueotomía/métodos , Traqueotomía/rehabilitaciónRESUMEN
PURPOSE: Cerebral palsy (CP) is the most common motor disability of childhood. Less is known about its prevalence and associated factors in Switzerland, so we aimed to fill this knowledge gap in one Swiss canton, evaluating the feasibility to build up a CP registry. METHODS: A retrospective review of medical records was undertaken. Children born during 1995 and 2009 in the canton of Saint Gallen diagnosed with CP were eligible for inclusion. RESULTS: A total of 140 patients formed the study cohort. The prevalence of CP was 0.19%, with 85% of children affected by spastic CP. CONCLUSIONS: The results of the present study were comparable with data of the Surveillance of Cerebral Palsy in Europe network. Moreover, this pilot study demonstrated the feasibility and usefulness of creating a registry of children affected by CP.