Traqueostomía en cuidados intensivos en pacientes COVID-19

Abstract

IntroductionCommunity-acquired pneumonia due to COVID-19 has been a recent and frequent cause of admission to intensive care units worldwide. Its rapid expansion and high number of cases mean that there are many open questions regarding its management, treatment and prognosis. One of these is the performing of a tracheostomy in patients affected by this pneumonia admitted to intensive care. Material and methodsA retrospective, observational study was carried out on all the patients admitted to the Intensive Medicine Department at a University Hospital with the clinical or analytical diagnosis of COVID-19 pneumonia. An analysis was performed on all patients that required mechanical ventilation connection and tracheostomy during their management. ResultsA total of 37 patients were analysed, of whom 70.3% (26/37) were male. The mean age was 59.4±9.4, and the APACHE II score was 14.8±4.67. The mean number of days of mechanical ventilation prior to the performing of the tracheostomy was 11±2.66. On 3 occasions it was done during the first week, and on 31 occasions during the second. Percutaneous tracheostomy was performed in 86.5% (32/37) of the cases, and 17 (46%) patients were decannulated. The mean number of days from tracheostomy to decannulation was 17.7±10.6 days, with 16 of these 17 patients having been discharged from the hospital. In the study sample, the type of technique was not associated with a higher mortality or complication rate. ConclusionsThe results are presented on 37 patients who required a tracheostomy as part of the management of COVID-19 pneumonia in a University Hospital, as well as a description of the technique performed and prognosis.