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Tracheotomy in the SARS-CoV-2 pandemic
Hunter Skoog1, Kirk Withrow1, Harishanker Jeyarajan1
1Department of Otolaryngology: Head and Neck Surgery, University of Alabama Birmingham, Birmingham, Alabama, USA.
Head & Neck
|April 29, 2020
Summary
Surgeons performing tracheotomy during the COVID-19 pandemic must adapt procedures. New guidelines are essential to protect healthcare workers from aerosol-generating procedures (AGP) and prevent viral spread.
Area of Science:
- Critical Care Medicine
- Infectious Disease Epidemiology
- Surgical Procedures
Background:
- The COVID-19 pandemic has led to increased cases of chronic respiratory failure and ventilator dependence.
- Tracheotomy is frequently required for prolonged mechanical ventilation.
- Aerosol-generating procedures (AGP), including tracheotomy, pose significant infection risks to healthcare personnel and can accelerate viral dissemination.
Purpose of the Study:
- To review existing evidence on best practices for tracheotomy during the SARS-CoV-2 pandemic.
- To develop straightforward guidelines for performing tracheotomy in the context of COVID-19.
- To address the risks associated with AGP in a pandemic setting.
Main Methods:
- A comprehensive review of current national and international experience with the SARS-CoV-2 pandemic.
- Incorporation of lessons learned from the 2002/2003 SARS epidemic.
- Development of evidence-based, practical guidelines for tracheotomy procedures.
Main Results:
- Traditional tracheotomy management may be inadequate or harmful during the COVID-19 pandemic.
- A modified approach to tracheotomy is necessary to mitigate infection risks.
- Guidelines aim to ensure patient safety and healthcare worker protection.
Conclusions:
- A thoughtful and evidence-informed approach to tracheotomy is imperative during the SARS-CoV-2 pandemic.
- Adherence to updated guidelines is crucial for minimizing transmission risks.
- These guidelines provide a framework for safe surgical management of ventilator-dependent patients.
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