Timing of elective tracheotomy and duration of mechanical ventilation among patients admitted to intensive care with severe COVID ‐19: A multicenter prospective cohort study
| Autor: | Gabriela Simonetti, Vanessa Villarraga, Albert Prats-Uribe, Estefania Hernandez-Garcia, Clara Garcia-Bastida, Nieves Mata-Castro, Carlos M. Chiesa-Estomba, Pablo Parente-Arias, Victoria Duque Holguera, Alvaro Sanchez Barrueco, Laura Rodriganez, Jordi Rello, Isabel Vilaseca, Daniel Poletti, Jose Miguel Villacampa, Adriana Agüero, Carla Meler-Claramonte, Marc Tobed, Jose Ignacio Tato, Pedro Castro, Maria Casasayas, Daniel Prieto-Alhambra, Francesc Xavier Avilés-Jurado |
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| Rok vydání: | 2021 |
| Předmět: |
Critical Care
complications medicine.medical_treatment Rate ratio SARS‐CoV‐2 Tracheotomy Intensive care medicine Humans Prospective Studies Prospective cohort study intensive care Mechanical ventilation SARS-CoV-2 business.industry weaning Mortality rate Hazard ratio respiratory failure COVID-19 Original Articles Respiration Artificial Intensive Care Units Otorhinolaryngology Respiratory failure Anesthesia Original Article business |
| Zdroj: | Head & Neck HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
| ISSN: | 1097-0347 1043-3074 |
| DOI: | 10.1002/hed.26863 |
| Popis: | Background Optimal timing for tracheotomy for critically ill COVID‐19 patients requiring invasive mechanical ventilation (IMV) is not established. Methods Multicenter prospective cohort including all COVID‐19 patients admitted to intensive care units (ICUs) in 36 hospitals who required tracheotomy during first pandemic wave. With a target emulation trial framework, we studied the causal effects of early (7–10 days) versus late (>10 days) tracheotomy (LT) on time from tracheotomy to weaning, postoperative mortality, and tracheotomy complications. Results Of 696 patients, 20.4% received early tracheotomy (ET). ET was associated with faster weaning (hazard ratio [HR] [95% confidence interval, CI]: 1.25 [1.00–1.56]) without differences in mortality (HR [95% CI]: 0.85 [0.60–1.21]) or complications (adjusted rate ratio [95% CI]: 0.56 [0.23–1.33]). Conclusions ET had a similar or lower post‐tracheotomy weaning time than LT, potentially shortening IMV and ICU stays, without changing complication or mortality rates in COVID‐19 patients. |
| Databáze: | OpenAIRE |
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