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Tracheostomy in the COVID-19 pandemic
Francesco Mattioli1, Matteo Fermi2, Michael Ghirelli2
1Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Via del Pozzo 71, 41100, Modena, Italy. franz318@hotmail.com.
Summary
Tracheostomy in COVID-19 ARDS patients is debated. This study found no difference between tracheostomy types and no team infections, suggesting careful patient selection for this procedure.
Area of Science:
- Critical Care Medicine
- Otolaryngology
- Infectious Diseases
Background:
- The role and optimal timing of tracheostomy in patients with COVID-19-related Acute Respiratory Distress Syndrome (ARDS) remain unclear.
- Current clinical guidelines lack specific indications for tracheostomy in this patient population.
Purpose of the Study:
- To explore the experience and outcomes of tracheostomy in patients with COVID-19 ARDS.
- To address controversial aspects of tracheostomy timing and safety in this specific cohort.
Main Methods:
- A retrospective analysis of 28 tracheostomies performed on COVID-19 ARDS patients receiving invasive mechanical ventilation (IMV).
- Synergic experience between Ear, Nose, and Throat (ENT) and Intensive Care Unit (ICU) departments was documented.
Main Results:
- No significant differences were observed in the timing of tracheostomy between percutaneous and surgical approaches.
- No instances of healthcare team viral infection were reported during the procedures.
Conclusions:
- Tracheostomy in COVID-19 ARDS patients should be reserved for carefully selected individuals.
- The optimal timing for tracheostomy appears to be between 7 and 14 days after initial orotracheal intubation.
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