Tracheostomy in the intensive care unit: Guidelines during COVID-19 worldwide pandemic
| Autor: | Gustavo Garcia Fornari, Juan Montagne, Marcelo Figari, David Smith, Marcos Las Heras, Juan Eduardo San Roman, Agustin Dietrich, Indalecio Carboni Bisso, Micaela Raices |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Critical Care medicine.medical_treatment Pneumonia Viral Article law.invention 03 medical and health sciences Betacoronavirus 0302 clinical medicine Tracheostomy Bronchoscopy Clinical Protocols law Intensive care Personal protective equipment Health care medicine Intubation Humans 030223 otorhinolaryngology Intensive care medicine Pandemics Pulmonologists Percutaneous Infection Control medicine.diagnostic_test business.industry SARS-CoV-2 Patient Selection COVID-19 Guideline Intensive care unit Otorhinolaryngology 030220 oncology & carcinogenesis business Coronavirus Infections |
| Zdroj: | American Journal of Otolaryngology |
| ISSN: | 1532-818X 0196-0709 |
| Popis: | Purpose COVID-19 has become a pandemic with significant consequences worldwide. About 3.2% of patients with COVID-19 will require intubation and invasive ventilation. Moreover, there will be an increase in the number of critically ill patients, hospitalized and intubated due to unrelated acute pathology, who will present underlying asymptomatic or mild forms of COVID-19. Tracheostomy is one of the procedures associated with an increased production of aerosols and higher risk of transmission of the virus to the health personnel. The aim of this paper is to describe indications and recommended technique of tracheostomy in COVID-19 patients, emphasizing the safety of the patient but also the medical team involved. Materials and methods A multidisciplinary group made up of surgeons with privileges to perform tracheostomies, intensive care physicians, infectious diseases specialists and intensive pulmonologists was created to update previous knowledge on performing a tracheostomy in critically ill adult patients (>18 years) amidst the SARS-CoV-2 pandemic in a high-volume referral center. Published evidence was collected using a systematic search and review of published studies. Results A guideline comprising indications, surgical technique, ventilator settings, personal protective equipment and timing of tracheostomy in COVID-19 patients was developed. Conclusions A safe approach to performing percutaneous dilational bedside tracheostomy with bronchoscopic guidance is feasible in COVID-19 patients of appropriate security measures are taken and a strict protocol is followed. Instruction of all the health care personnel involves is key to ensure their safety and the patient's favorable recovery. |
| Databáze: | OpenAIRE |
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