Development of an institutional protocol for percutaneous dilatational tracheostomy in critically ill COVID-19 patients : Initial experience
Copyright: © 2022 Journal of Anaesthesiology Clinical Pharmacology..
Background and Aims: Percutaneous dilatational tracheostomy (PDT) may improve the outcome in critically ill COVID-19 patients on mechanical ventilation. However, the timing of performing tracheostomy may be controversial, and it is an aerosol-generating procedure with a potential risk of viral exposure to healthcare workers.
Material and Methods: An operational protocol for performing PDT was made and subsequently followed in a designated COVID-19 ICU. Critically ill adult patients on mechanical ventilators who underwent PDT were included in this retrospective cohort study. Case files were retrospectively reviewed and patient characteristics, clinical outcome, and procedure-related details were noted.
Results: Forty-one patients were included in the analysis. The median age was 49 (39-67) years, and 41.5% of patients were females. The median duration of mechanical ventilation before tracheostomy was 10 (8-16) days, and the median (IQR) PaO2/FiO2 ratio on the day of PDT was 155 (125-180) mm Hg. Further, 48.8% of patients had transient desaturation to SpO2 <90%, and 41.5% survived to ICU discharge. None of the health care providers involved in PDT developed any symptoms of COVID 19.
Conclusion: This descriptive study demonstrates the feasibility, implementation, and apparent safety of the PDT protocol developed at our institution.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
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| Enthalten in: |
Journal of anaesthesiology, clinical pharmacology - 38(2022), Suppl 1 vom: 26. Juli, Seite S102-S106 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Damarla, Haritha [VerfasserIn] |
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| Links: |
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| Themen: |
Coronavirus disease 2019 |
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| Anmerkungen: |
Date Revised 07.09.2022 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.4103/joacp.joacp_495_21 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM345774078 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright: © 2022 Journal of Anaesthesiology Clinical Pharmacology. | ||
| 520 | |a Background and Aims: Percutaneous dilatational tracheostomy (PDT) may improve the outcome in critically ill COVID-19 patients on mechanical ventilation. However, the timing of performing tracheostomy may be controversial, and it is an aerosol-generating procedure with a potential risk of viral exposure to healthcare workers | ||
| 520 | |a Material and Methods: An operational protocol for performing PDT was made and subsequently followed in a designated COVID-19 ICU. Critically ill adult patients on mechanical ventilators who underwent PDT were included in this retrospective cohort study. Case files were retrospectively reviewed and patient characteristics, clinical outcome, and procedure-related details were noted | ||
| 520 | |a Results: Forty-one patients were included in the analysis. The median age was 49 (39-67) years, and 41.5% of patients were females. The median duration of mechanical ventilation before tracheostomy was 10 (8-16) days, and the median (IQR) PaO2/FiO2 ratio on the day of PDT was 155 (125-180) mm Hg. Further, 48.8% of patients had transient desaturation to SpO2 <90%, and 41.5% survived to ICU discharge. None of the health care providers involved in PDT developed any symptoms of COVID 19 | ||
| 520 | |a Conclusion: This descriptive study demonstrates the feasibility, implementation, and apparent safety of the PDT protocol developed at our institution | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Coronavirus disease 2019 | |
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| 650 | 4 | |a percutaneous dilatational tracheostomy | |
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