Tracheostomy in critically ill patients with SARS 2 COVID-19 infection: a prospective observational multi-center study of short- and long-term outcomes.

Autor:	Corona A; Emergency Anesthesia and Intensive Care Medicine Department, Esine and Edolo Hospital, ASST Valcamonica, Brescia, Italy., De Santis V; Department of Anesthesia and Intensive Care Medicine, Ospedale Umberto I, Lugo, Italy., Vitale D; Department of Anesthesia and Intensive Care Medicine, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy., Nencini C; Department of Anesthesia and Intensive Care Medicine, Ospedale Santa Maria delle Croci, Ravenna, Italy., Potalivo A; Department of Anesthesia and Intensive Care Medicine, Ospedale 'Infermi' Rimini, Rimini, Italy., Prete A; Department of Anesthesia and Intensive Care Medicine, Ospedale Umberto I, Lugo, Italy., Barzaghi N; Department of Anesthesia and Intensive Care Medicine, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy., Tardivo S; Department of Anesthesia and Intensive Care Medicine, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy., Terzitta M; Department of Anesthesia and Intensive Care Medicine, Ospedale 'Ceccarini' Riccione, Italy., Malfatto A; Department of Anesthesia and Intensive Care Medicine, Ospedale di Bentivoglio Azienda USL Bologna, Bologna, Italy., Tritapepe L; Department of Anesthesia and Intensive Care Medicine, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy., Locatelli A; Department of Anesthesia and Intensive Care Medicine, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy., Singer M; Bloomsbury Institute of Intensive Care Medicine, University College London, London, UK.
Jazyk:	angličtina
Zdroj:	Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR [Can J Respir Ther] 2022 Sep 30; Vol. 58, pp. 155-161. Date of Electronic Publication: 2022 Sep 30 (Print Publication: 2022).
DOI:	10.29390/cjrt-2022-018
Abstrakt:	Background: We report the characteristics, timing, and factors related to the decision to perform a tracheostomy in patients with confirmed COVID-19 infection admitted to eight Italian intensive care units (ICUs). Materials and Methods: Prospective observational cohort study of patients with COVID-19 disease on mechanical ventilation. Long-term functional impairment (up to 180 days' post-hospital discharge) was assessed using the Karnofsky scale. Kaplan-Meier analysis assessed differences in survival and freedom from tracheostomy in relation to ICU stay. Cox regression model was used to assess which variables impacted on tracheostomy as a categorical outcome. Results: A total of 248 patients were recruited in the eight participating ICUs. Patients undergoing tracheostomy ( n = 128) had longer ICU (25 (18-36) vs. 10 (7-16), P = 0.001) and hospital (37 (26.5-50) vs. 19 (8.5-34.5) P = 0.02) stays. ICU and hospital mortality of patients tracheostomized was 34% and 37%, respectively. Cumulative survival Kaplan-Meier analysis documented improved survival rates in patients undergoing tracheostomy (Log-Rank, Mantel-Cox = 4.8, P = 0.028). Median Karnofsky scale values improved over time but were similar between survivors receiving or not receiving tracheostomy. No healthcare worker involved in the tracheostomy procedure developed COVID-19 infection during the study period. Conclusions: Patients with COVID-19 infection who underwent tracheostomy had a better cumulative survival but similar long-term functional outcomes at 30, 60, and 180 days after hospital discharge. Competing Interests: No conflicts of interest to declare.
Databáze:	MEDLINE
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