Modified percutaneous tracheostomy in patients with COVID-19
Background Patients hospitalized with COVID-19 are at risk of developing hypoxic respiratory failure and often require prolonged mechanical ventilation. Indication and timing to perform tracheostomy is controversial in patients with COVID-19.Methods This was a single-institution retrospective review...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-12-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/5/1/e000625.full |
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| author | David A Spain Thomas G Weiser Joseph D Forrester Beatrice J Sun Christopher J Wolff Hannah M Bechtold Dwayne Free Javier Lorenzo Patrick R Minot Paul G Maggio |
| author_facet | David A Spain Thomas G Weiser Joseph D Forrester Beatrice J Sun Christopher J Wolff Hannah M Bechtold Dwayne Free Javier Lorenzo Patrick R Minot Paul G Maggio |
| author_sort | David A Spain |
| collection | DOAJ |
| description | Background Patients hospitalized with COVID-19 are at risk of developing hypoxic respiratory failure and often require prolonged mechanical ventilation. Indication and timing to perform tracheostomy is controversial in patients with COVID-19.Methods This was a single-institution retrospective review of tracheostomies performed on patients admitted for COVID-19 between April 8, 2020 and August 1, 2020 using a modified percutaneous tracheostomy technique to minimize hypoxia and aerosolization.Results Twelve tracheostomies were performed for COVID-related respiratory failure. Median patient age was 54 years (range: 36–76) and 9 (75%) were male. Median time to tracheostomy was 17 days (range: 10–27), and 5 (42%) patients had failed attempts at extubation prior to tracheostomy. There were no intraprocedural complications, including hypoxia. Post-tracheostomy bleeding was noted in two patients. Eight (67%) patients have been discharged at the time of this study, and there were four patient deaths unrelated to tracheostomy placement. No healthcare worker transmissions resulted from participating in the tracheostomy procedure.Conclusions A modified percutaneous tracheostomy is feasible and can be safely performed in patients infected with COVID-19.Level of evidence Level V, case series. |
| format | Article |
| id | doaj-art-0e5281499b7642e7a6b5cfdafc0dba5f |
| institution | OA Journals |
| issn | 2397-5776 |
| language | English |
| publishDate | 2020-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj-art-0e5281499b7642e7a6b5cfdafc0dba5f2025-08-20T02:12:33ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762020-12-015110.1136/tsaco-2020-000625Modified percutaneous tracheostomy in patients with COVID-19David A Spain0Thomas G Weiser1Joseph D Forrester2Beatrice J Sun3Christopher J Wolff4Hannah M Bechtold5Dwayne Free6Javier Lorenzo7Patrick R Minot8Paul G Maggio9Department of Surgery, Stanford University, Stanford, California, USADepartment of Surgery, Stanford University, Stanford, California, USA1 Department of Surgery, Stanford University, Stanford, California, USADepartment of Surgery, Stanford University, Stanford, California, USADepartment of Surgery, Stanford University, Stanford, California, USAAnesthesiology, Stanford University, Stanford, California, USABronchoscopy and Respiratory Care Services, Stanford University, Stanford, California, USAAnesthesiology, Stanford University, Stanford, California, USAAnesthesiology, Stanford University, Stanford, California, USADepartment of Surgery, Stanford University, Stanford, California, USABackground Patients hospitalized with COVID-19 are at risk of developing hypoxic respiratory failure and often require prolonged mechanical ventilation. Indication and timing to perform tracheostomy is controversial in patients with COVID-19.Methods This was a single-institution retrospective review of tracheostomies performed on patients admitted for COVID-19 between April 8, 2020 and August 1, 2020 using a modified percutaneous tracheostomy technique to minimize hypoxia and aerosolization.Results Twelve tracheostomies were performed for COVID-related respiratory failure. Median patient age was 54 years (range: 36–76) and 9 (75%) were male. Median time to tracheostomy was 17 days (range: 10–27), and 5 (42%) patients had failed attempts at extubation prior to tracheostomy. There were no intraprocedural complications, including hypoxia. Post-tracheostomy bleeding was noted in two patients. Eight (67%) patients have been discharged at the time of this study, and there were four patient deaths unrelated to tracheostomy placement. No healthcare worker transmissions resulted from participating in the tracheostomy procedure.Conclusions A modified percutaneous tracheostomy is feasible and can be safely performed in patients infected with COVID-19.Level of evidence Level V, case series.https://tsaco.bmj.com/content/5/1/e000625.full |
| spellingShingle | David A Spain Thomas G Weiser Joseph D Forrester Beatrice J Sun Christopher J Wolff Hannah M Bechtold Dwayne Free Javier Lorenzo Patrick R Minot Paul G Maggio Modified percutaneous tracheostomy in patients with COVID-19 Trauma Surgery & Acute Care Open |
| title | Modified percutaneous tracheostomy in patients with COVID-19 |
| title_full | Modified percutaneous tracheostomy in patients with COVID-19 |
| title_fullStr | Modified percutaneous tracheostomy in patients with COVID-19 |
| title_full_unstemmed | Modified percutaneous tracheostomy in patients with COVID-19 |
| title_short | Modified percutaneous tracheostomy in patients with COVID-19 |
| title_sort | modified percutaneous tracheostomy in patients with covid 19 |
| url | https://tsaco.bmj.com/content/5/1/e000625.full |
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