Tracheostomy Practice and Outcomes in Patients with COVID–19 ARDS – insights from PRoVENT–COVID

Abstract

<b>Introduction:</b> Little is known about tracheostomy practice in COVID-19 ARDS patients in the Netherlands. <b>Aim:</b> To ascertain practice and outcomes of tracheostomy in COVID–19 ARDS patients during the first 3 months of the pandemic. <b>Methods:</b> Multicenter observational study incorporating data from 22 centers. Endpoints were incidence (primary), timing and outcome of tracheostomy. <b>Results:</b> Tracheostomy was performed in 189/1023 (18.5%) patients at median 21 [17-28] days; timing did not change over time (Fig 1). Tracheostomy performed ≤ 21 days was associated with shorter duration of ventilation (median 26 [21–32] vs 40 [34–47] days; P&lt;0.001) and with higher ICU (22 vs 10%; P=0.016), hospital (26 vs 12%; P=0.007) and day–90 mortality (28 vs 15%; P=0.004) (Fig 2). Prone positioning was associated with later timing of tracheostomy. <b>Conclusions:</b> Incidence of tracheostomy in COVID-19 ARDS patients in the Netherlands is comparable to that of international cohorts of ARDS and COVID-19 ARDS patients, but timing is later. Controlled studies are necessary to clarify the relationship between timing of tracheostomy and outcomes.