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Tytuł:
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Elective Tracheostomy During Mechanical Ventilation in Patients Affected by COVID-19: Preliminary Case Series From Lombardy, Italy.
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Autorzy:
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Turri-Zanoni M; Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Battaglia P; Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Czaczkes C; Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Pelosi P; Anesthesiology and Intensive Care Unit, University of Genoa, Italy.; San Martino Policlinico Hospital, Genoa, Italy.
Castelnuovo P; Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Cabrini L; Anesthesiology and Intensive Care Unit, University of Insubria, Varese, Italy.; Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
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Źródło:
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Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2020 Jul; Vol. 163 (1), pp. 135-137. Date of Electronic Publication: 2020 May 12.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2023- : [Oxford] : Wiley
Original Publication: [Rochester, Minn.] : The Academy, [c1981-
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MeSH Terms:
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Betacoronavirus*
Intensive Care Units*
Coronavirus Infections/*complications
Disease Transmission, Infectious/*prevention & control
Pneumonia, Viral/*complications
Respiration, Artificial/*methods
Respiratory Insufficiency/*therapy
Tracheostomy/*methods
Adult ; Aged ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/transmission ; Elective Surgical Procedures ; Female ; Follow-Up Studies ; Humans ; Incidence ; Italy/epidemiology ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/transmission ; Respiratory Insufficiency/epidemiology ; Respiratory Insufficiency/etiology ; SARS-CoV-2 ; Treatment Outcome
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Contributed Indexing:
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Keywords: COVID-19; coronavirus pandemic; intensive care unit; personal protective equipment; tracheostomy
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Entry Date(s):
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Date Created: 20200513 Date Completed: 20200715 Latest Revision: 20201218
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Update Code:
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20240105
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DOI:
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10.1177/0194599820928963
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PMID:
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32396455
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The COVID-19 outbreak poses continued struggles due to the unprecedented number of patients admitted to intensive care units and the overwhelming need for mechanical ventilation. We report a preliminary case series of 32 patients with COVID-19 who underwent elective tracheostomies after a mean intubation period of 15 days (range, 9-21 days). The procedure was performed with percutaneous (10 cases) and open (22 cases) surgical techniques. Neither procedure-related complications nor viral transmission to health care workers was observed. Our preliminary experience supports the safety of tracheostomy, provided that appropriate protocols are strictly followed. The postoperative care is still debated, and, prudentially, our protocol includes tracheal tube change not before 2 weeks after tracheostomy, with cuff deflation and decannulation deferred until confirmation of negative SARS-CoV-2 test results. This is the first case series to report on such a rapidly evolving issue and might represent a source of information for clinicians worldwide who will soon be facing the same challenges.
