Endoscopy-assisted dilatational tracheostomy in patients with COVID-19

Abstract

To summarize an experience of endoscopy-assisted dilatational tracheostomies in patients with COVID-19. There were 31 endoscopy-assisted dilatational tracheostomies in patients with COVID-19 for the period from April 17 to June 10, 2020 (11 women and 19 men). Mean age of patients was 66.7 years (range 48-87). Tracheostomy was performed using Ciaglia (22) and Griggs (9) techniques. All procedures were carried out at the intensive care unit in elective fashion. Tracheostomy was performed in 19.8% of ICU patients or 36.9% of all patients on mechanical ventilation within 6.5±2.5 days [min 3, max 11]. There were 22 survivors with tracheostomy (70.9%) that is comparable with survival of patients without mechanical ventilation (79.7%) and slightly higher than in patients on ventilation without tracheostomy (65.4%). No complications during the procedure were noted. Endoscopy-assisted dilatational tracheostomy is preferred for prolonged mechanical ventilation, including patients with COVID-19. The undeniable advantages of this operation are fewer intraoperative complications due to endoscopic control, and lower risk of tracheal strictures.