Outcomes After Tracheostomy in COVID-19 Patients
| Autor: | Andrew R. Haas, Christopher H. Rassekh, Joshua H. Atkins, Ara A. Chalian, Niels D. Martin, James Kearney, Karthik Rajasekaran, Sean P. Harbison, Leah D. Lambe, Christoph T. Hutchinson, Maurizio Cereda, Beatrice Go, Tiffany N. Chao, Benjamin M. Braslow, Ellen A. Paul |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
invasive mechanical ventilation
Adult Male ARDS Coronavirus disease 2019 (COVID-19) Critical Care medicine.medical_treatment Context (language use) tracheostomy intubation 03 medical and health sciences Young Adult 0302 clinical medicine Extracorporeal Membrane Oxygenation medicine Extracorporeal membrane oxygenation Intubation Intratracheal Intubation Humans Acute respiratory failure Prospective Studies Prospective cohort study Aged Aged 80 and over business.industry SARS-CoV-2 aerosol-generating procedures COVID-19 Middle Aged medicine.disease Respiration Artificial Treatment Outcome 030220 oncology & carcinogenesis Anesthesia personal protective equipment 030211 gastroenterology & hepatology Female Surgery Covid Papers business Cohort study |
| Zdroj: | Annals of Surgery |
| ISSN: | 1528-1140 0003-4932 |
| DOI: | 10.1097/sla.0000000000004166 |
| Popis: | Objective: To determine the outcomes of patients undergoing tracheostomy for COVID-19 and of healthcare workers performing these procedures. Background: Tracheostomy is often performed for prolonged endotracheal intubation in critically ill patients. However, in the context of COVID-19, tracheostomy placement pathways have been altered due to the poor prognosis of intubated patients and the risk of transmission to providers through this highly aerosolizing procedure. Methods: A prospective single-system multi-center observational cohort study was performed on patients who underwent tracheostomy after acute respiratory failure secondary to COVID-19. Results: Of the 53 patients who underwent tracheostomy, the average time from endotracheal intubation to tracheostomy was 19.7 days ± 6.9 days. The most common indication for tracheostomy was acute respiratory distress syndrome, followed by failure to wean ventilation and post-extracorporeal membrane oxygenation decannulation. Thirty patients (56.6%) were liberated from the ventilator, 16 (30.2%) have been discharged alive, 7 (13.2%) have been decannulated, and 6 (11.3%) died. The average time from tracheostomy to ventilator liberation was 11.8 days ± 6.9 days (range 2–32 days). Both open surgical and percutaneous dilational tracheostomy techniques were performed utilizing methods to mitigate aerosols. No healthcare worker transmissions resulted from performing the procedure. Conclusions: Alterations to tracheostomy practices and processes were successfully instituted. Following these steps, tracheostomy in COVID-19 intubated patients seems safe for both patients and healthcare workers performing the procedure. |
| Databáze: | OpenAIRE |
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