Tracheostomy During the COVID-19 Pandemic: Comparison of International Perioperative Care Protocols and Practices in 26 Countries.

Autor: Bier-Laning C; Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, USA., Cramer JD; Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA., Roy S; Department of Otorhinolaryngology-Head and Neck Surgery, Children's Memorial Hermann Hospital, University of Texas Medical School, Houston, Texas, USA., Palmieri PA; Office of the Vice Chancellor for Research, Universidad Norbert Wiener, Lima, Peru.; EBHC South America: A Joanna Briggs Affiliated Group, Lima, Peru., Amin A; Head and Neck Department, National Cancer Institute, Cairo University, Egypt., Añon JM; La Paz-Carlos III University Hospital, IdiPAZ, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain., Bonilla-Asalde CA; Hospital Nacional Daniel Alcides Carrión, Lima, Perú.; Universidad Privada San Juan Bautista, Lima, Perú., Bradley PJ; Department of Otolaryngology, Head and Neck Oncologic Surgery, University of Nottingham, Nottingham, UK., Chaturvedi P; Department of Head & Neck Surgical Oncology, Tata Memorial Centre, Mumbai, India., Cognetti DM; Department of Otolaryngology-Head & Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Philadelphia, USA., Dias F; Head and Neck Surgery Service, Brazilian National Cancer Institute, Chairman, Department of Head and Neck Surgery, Post-Graduation School of Medicine, Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil., Di Stadio A; Department of Otolaryngology, University of Perugia, Perugia, Italy., Fagan JJ; Division of Otorhinolaryngology (ENT), University of Cape Town, Cape Town, South Africa., Feller-Kopman DJ; Departments of Medicine, Anesthesiology and Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Hao SP; Department of Otorhinolaryngology-Head & Neck Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei.; Department of Otorhinolaryngology-Head & Neck Surgery, Fu Jen Catholic University School of Medicine, New Taipei City., Kim KH; Department of Otolaryngology-Head and Neck Surgery and Cancer Research Institute, Bundang Jesaeng Hospital Seoul National University College of Medicine, Seoul, Korea., Koivunen P; Department of Otolaryngology, Oulu University Hospital, Oulu, Finland., Loh WS; Department of Otolaryngology-Head and Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Mansour J; Department of Otorhinolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel., Naunheim MR; Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA., Schultz MJ; Department of Intensive Care & Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·CA), Amsterdam University Medical Centers, location AMC, Amsterdam, the Netherlands.; Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand.; Nuffield Department of Medicine, University of Oxford, Oxford, UK., Shang Y; Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Sirjani DB; Department of Otorhinolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA., St John MA; Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.; Jonsson Comprehensive Cancer Center, UCLA Medical Center, Los Angeles, California, USA.; UCLA Head and Neck Cancer Program, UCLA Medical Center, Los Angeles, California, USA., Tay JK; Department of Otolaryngology-Head and Neck Surgery, National University of Singapore, Singapore., Vergez S; Department of Otolaryngology-Head & Neck Surgery, University Hospital Rangueil-Larrey, Toulouse, France., Weinreich HM; Department of Otolaryngology, University of Illinois College of Medicine, Chicago, Illinois, USA., Wong EWY; Department of Otorhinolaryngology, Head & Neck Surgery, Chinese University of Hong Kong, Hong Kong., Zenk J; Universitätsklinikum Augsburg Klinik für HNO-Heilkunde, Augsburg, Germany., Rassekh CH; Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Brenner MJ; Department of Otolaryngology-Head & Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.; Global Tracheostomy Collaborative, Raleigh, North Carolina, USA.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2021 Jun; Vol. 164 (6), pp. 1136-1147. Date of Electronic Publication: 2020 Nov 03.
DOI: 10.1177/0194599820961985
Abstrakt: Objective: The coronavirus disease 2019 (COVID-19) pandemic has led to a global surge in critically ill patients requiring invasive mechanical ventilation, some of whom may benefit from tracheostomy. Decisions on if, when, and how to perform tracheostomy in patients with COVID-19 have major implications for patients, clinicians, and hospitals. We investigated the tracheostomy protocols and practices that institutions around the world have put into place in response to the COVID-19 pandemic.
Data Sources: Protocols for tracheostomy in patients with severe acute respiratory syndrome coronavirus 2 infection from individual institutions (n = 59) were obtained from the United States and 25 other countries, including data from several low- and middle-income countries, 23 published or society-endorsed protocols, and 36 institutional protocols.
Review Methods: The comparative document analysis involved cross-sectional review of institutional protocols and practices. Data sources were analyzed for timing of tracheostomy, contraindications, preoperative testing, personal protective equipment (PPE), surgical technique, and postoperative management.
Conclusions: Timing of tracheostomy varied from 3 to >21 days, with over 90% of protocols recommending 14 days of intubation prior to tracheostomy. Most protocols advocate delaying tracheostomy until COVID-19 testing was negative. All protocols involved use of N95 or higher PPE. Both open and percutaneous techniques were reported. Timing of tracheostomy changes ranged from 5 to >30 days postoperatively, sometimes contingent on negative COVID-19 test results.
Implications for Practice: Wide variation exists in tracheostomy protocols, reflecting geographical variation, different resource constraints, and limited data to drive evidence-based care standards. Findings presented herein may provide reference points and a framework for evolving care standards.
Databáze: MEDLINE
Externí odkaz: