Open Tracheostomy for Critically Ill Patients with COVID-19.

Estefanía Hernández-García,Carlos Velayos,Andrés Navarro Mediano,Belen Rodríguez-Campoo,Nuria Pérez-Martín,Victoria García-Peces,Mar Martínez-Ruizcoello,Guillermo Plaza,Gerd J Ridder

doi:10.1155/2020/8861013

Estefanía Hernández-García, Carlos Velayos + Show 7 more

Open Access

https://doi.org/10.1155/2020/8861013

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Abstract

Background COVID-19 is a worldwide pandemic, with many patients requiring prolonged mechanical ventilation. Tracheostomy can shorten ICU length of stay and help weaning. Aims/Objectives. To describe the long-term evolution of the critically patient with COVID-19 and the need for invasive mechanical ventilation and orotracheal intubation (OTI), with or without tracheostomy. Material and Methods. A prospective study was performed including all patients admitted to the ICU due to COVID-19 from 10th March to 30th April 2020. Epidemiological data, performing a tracheostomy or not, mean time of invasive mechanical ventilation until tracheotomy, mean time from tracheotomy to weaning, and final outcome after one month of minimum follow-up were recorded. The Otolaryngology team was tested for COVID-19 before and after the procedures. Results Out of a total of 1612 hospital admissions for COVID-19, only 5.8% (93 patients) required ICU admission and IOT. Twenty-seven patients (29%) underwent a tracheostomy. After three months, within the group of tracheotomized patients, 29.6% died and 48.15% were extubated in a mean time of 28.53 days. In the nontracheostomized patients, the mortality was 42.4%. Conclusions Tracheostomy is a safe procedure for COVID-19 and helps weaning of prolonged OTI. Mortality after tracheostomy was less common than in nontracheostomized patients.

Highlights

COVID-19 is a worldwide pandemic that is putting unprecedented demand on intensive care units (ICU) and hospitals [1]. erefore, the number of orotracheal intubations (OTI) has increased to the same extent, requiring in most cases prolonged invasive mechanical ventilation.ere is current uncertainty about the role of tracheostomy for weaning of mechanically ventilated patients with COVID-19
We recapitulate the result of the diagnostic RT-PCR test, number of tests required until diagnosis, mean time until admission to the ICU and OTI or presence of bilateral or unilateral pneumonia, if it was necessary to perform a tracheostomy or not, mean time of invasive mechanical ventilation until tracheotomy, mean time from tracheotomy to weaning, mean time of ICU stay, treatment received, main recorded systemic complications, and final outcome
We present a prospective cohort of 1612 patients admitted for COVID-19 from 10th March 2020 to 30th April 2020 at a university hospital, representing a 0.8% of the total population of the city belonging to this health area

Summary

Background

COVID-19 is a worldwide pandemic, with many patients requiring prolonged mechanical ventilation. Tracheostomy can shorten ICU length of stay and help weaning. To describe the long-term evolution of the critically patient with COVID-19 and the need for invasive mechanical ventilation and orotracheal intubation (OTI), with or without tracheostomy. A prospective study was performed including all patients admitted to the ICU due to COVID-19 from 10th March to 30th April 2020. Epidemiological data, performing a tracheostomy or not, mean time of invasive mechanical ventilation until tracheotomy, mean time from tracheotomy to weaning, and final outcome after one month of minimum followup were recorded. Out of a total of 1612 hospital admissions for COVID-19, only 5.8% (93 patients) required ICU admission and IOT. Tracheostomy is a safe procedure for COVID-19 and helps weaning of prolonged OTI. Mortality after tracheostomy was less common than in nontracheostomized patients

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