Data regarding safety of bedside surgical tracheostomy in novel coronavirus 2019 (COVID-19) mechanically ventilated patients admitted to the intensive care unit (ICU) are lacking. We performed this study to assess the safety of bedside surgical tracheostomy in COVID-19 patients admitted to ICU. This retrospective, single-center, cohort observational study (conducted between February, 23 and April, 30, 2020) was performed in our 45-bed dedicated COVID-19 ICU. Inclusion criteria were: a) age over 18 years; b) confirmed diagnosis of COVID-19 infection (with nasopharyngeal/oropharyngeal swab); c) invasive mechanical ventilation and d) clinical indication for tracheostomy. The objectives of this study were to describe: 1) perioperative complications, 2) perioperative alterations in respiratory gas exchange and 3) occurrence of COVID-19 infection among health-care providers involved into the procedure. A total of 125 COVID-19 patients were admitted to the ICU during the study period. Of those, 66 (53%) underwent tracheostomy. Tracheostomy was performed after a mean of 6.1 (+/- 2.1) days since ICU admission. Most of tracheostomies (47/66, 71%) were performed by intensivists and the mean time of the procedure was 22 (+/- 4.4) minutes. No intraprocedural complications was reported. Stoma infection and bleeding were reported in 2 patients and 7 patients, respectively, in the post-procedure period, without significant clinical consequences. The mean PaO2/FiO(2) was significantly lower at the end of tracheostomy (117.6 +/- 35.4) then at the beginning (133.4 +/- 39.2) or 24 hours before (135.8 +/- 51.3) the procedure. However, PaO2/FiO(2) progressively increased at 24 hours after tracheostomy (142 +/- 50.7). None of the members involved in the tracheotomy procedures developed COVID-19 infection. Bedside surgical tracheostomy appears to be feasible and safe, both for patients and for health care workers, during COVID-19 pandemic in an experienced center.

Safety of bedside surgical tracheostomy during COVID-19 pandemic: A retrospective observational study / Picetti, E; Fornaciari, A; Taccone, Fs; Malchiodi, L; Grossi, S; Di Lella, F; Falcioni, M; D'Angelo, G; Sani, E; Rossi, S. - In: PLOS ONE. - ISSN 1932-6203. - 15:9(2020). [10.1371/journal.pone.0240014]

Safety of bedside surgical tracheostomy during COVID-19 pandemic: A retrospective observational study

Di Lella F;
2020

Abstract

Data regarding safety of bedside surgical tracheostomy in novel coronavirus 2019 (COVID-19) mechanically ventilated patients admitted to the intensive care unit (ICU) are lacking. We performed this study to assess the safety of bedside surgical tracheostomy in COVID-19 patients admitted to ICU. This retrospective, single-center, cohort observational study (conducted between February, 23 and April, 30, 2020) was performed in our 45-bed dedicated COVID-19 ICU. Inclusion criteria were: a) age over 18 years; b) confirmed diagnosis of COVID-19 infection (with nasopharyngeal/oropharyngeal swab); c) invasive mechanical ventilation and d) clinical indication for tracheostomy. The objectives of this study were to describe: 1) perioperative complications, 2) perioperative alterations in respiratory gas exchange and 3) occurrence of COVID-19 infection among health-care providers involved into the procedure. A total of 125 COVID-19 patients were admitted to the ICU during the study period. Of those, 66 (53%) underwent tracheostomy. Tracheostomy was performed after a mean of 6.1 (+/- 2.1) days since ICU admission. Most of tracheostomies (47/66, 71%) were performed by intensivists and the mean time of the procedure was 22 (+/- 4.4) minutes. No intraprocedural complications was reported. Stoma infection and bleeding were reported in 2 patients and 7 patients, respectively, in the post-procedure period, without significant clinical consequences. The mean PaO2/FiO(2) was significantly lower at the end of tracheostomy (117.6 +/- 35.4) then at the beginning (133.4 +/- 39.2) or 24 hours before (135.8 +/- 51.3) the procedure. However, PaO2/FiO(2) progressively increased at 24 hours after tracheostomy (142 +/- 50.7). None of the members involved in the tracheotomy procedures developed COVID-19 infection. Bedside surgical tracheostomy appears to be feasible and safe, both for patients and for health care workers, during COVID-19 pandemic in an experienced center.
Safety of bedside surgical tracheostomy during COVID-19 pandemic: A retrospective observational study / Picetti, E; Fornaciari, A; Taccone, Fs; Malchiodi, L; Grossi, S; Di Lella, F; Falcioni, M; D'Angelo, G; Sani, E; Rossi, S. - In: PLOS ONE. - ISSN 1932-6203. - 15:9(2020). [10.1371/journal.pone.0240014]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2902762
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