Percutaneous tracheostomy for long-term ventilated COVID-19-patients: rationale and first clinical -safe for all- experience

Autor: Marian Vanhoeij, Daniel Jacobs-Tulleneers-Thevissen, Mark La Meir, Guy Verfaillie, Wim Jonckheere, Ina Foulon, Marc Diltoer, Jan Nijs, Ellen Van Eetvelde, Martijn Schoneveld, Michaël Mekeirele, Paul E. Wischmeyer, Katia Verbruggen, Domien Vanhonacker, Idris Ghijselings, Frans Gordts, Matthias Raes, Dirk Smets, Steven Hendrickx, Manu L N G Malbrain, Joop Jonckheer, Elisabeth De Waele
Přispěvatelé: Surgery, Faculty of Medicine and Pharmacy, Medicine and Pharmacy academic/administration, Intensive Care, Anesthesiology, Supporting clinical sciences, Electronics and Informatics, Surgical clinical sciences, Microbiology and Infection Control, Ear, nose & throat, Basic (bio-) Medical Sciences, Cardiac Surgery, Clinical sciences
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
medicine.medical_specialty
Complications
Critical Care
Coronavirus disease 2019 (COVID-19)
medicine.medical_treatment
Forceps
Postoperative Hemorrhage
Critical Care and Intensive Care Medicine
surgery
Tracheostomy
Bronchoscopy
Anesthesiology
guidewire dilating forceps tracheostomy
medicine
Humans
Minimally Invasive Surgical Procedures
Intubation
percutaneous tracheostomy
Anesthesia
RD78.3-87.3
Personal Protective Equipment
Aged
Retrospective Studies
Mechanical ventilation
medicine.diagnostic_test
RC86-88.9
business.industry
COVID-19
Medical emergencies. Critical care. Intensive care. First aid
Retrospective cohort study
General Medicine
Perioperative
Middle Aged
Surgical Instruments
Respiration
Artificial
Checklist
Anesthesiology and Pain Medicine
Emergency medicine
Percutaneous tracheostomy
Female
business
Ventilator Weaning
Zdroj: Anaesthesiology Intensive Therapy, Vol 52, Iss 5, Pp 366-372 (2020)
Popis: Introduction COVID-19 infection has resulted in thousands of critically ill patients admitted to ICUs and treated with mechanical ventilation. Percutaneous tracheostomy is a well-known technique utilised as a strategy to wean critically ill patients from mechanical ventilation. Worldwide differences exist in terms of methods, operators, and settings, and questions remain regarding timing and indications. If tracheostomy is to be performed in COVID-19 patients, a safe environment is needed for optimal care. Material and methods We present a guidewire dilating forceps tracheostomy procedure in COVID-19 patients that was optimised including apnoea-moments, protective clothing, checklists, and clear protocols. We performed a retrospective analysis of the outcome after tracheostomy in COVID-19 patients between March 2020 and May 2020. Results The follow-up of the first 16 patients, median age 62 years, revealed a median intubation time until tracheostomy of 18 days and median cannulation time of 20 days. The overall perioperative complication rate and complication rate while cannulated was 19%, mainly superficial bleeding. None of the healthcare providers involved in performing the procedure developed any symptoms of the disease. Conclusions This COVID-19-centred strategy based on flexibility, preparation, and cooperation between healthcare providers with different backgrounds facilitated percutaneous tracheostomy in COVID-19 patients without an increase in the overall complication rate or evidence of risk to healthcare providers. Our findings provide initial evidence that tracheostomy can be performed safely as a standard of care for COVID-19 patients requiring prolonged mechanical ventilation as was standard practice in ICU patients prior to the COVID-19 pandemic to promote ventilator weaning and patient recovery.
Databáze: OpenAIRE
Externí odkaz: