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Modified percutaneous tracheostomy in COVID-19 critically ill patients
Maria Vargas1, Gennaro Russo2, Carmine Iacovazzo1
1Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
Head & Neck
|May 22, 2020
Summary
A modified percutaneous tracheostomy (PT) technique for COVID-19 patients uses a smaller endotracheal tube (ETT) to reduce aerosol generation and enhance staff safety during the procedure.
Area of Science:
- Critical Care Medicine
- Respiratory Medicine
- Infectious Diseases
Background:
- Percutaneous tracheostomy (PT) in COVID-19 patients carries risks of aerosol generation during critical procedural steps.
- Enhanced staff safety and minimized aerosolization are crucial considerations for PT in this population.
Purpose of the Study:
- To report a modified PT technique designed to decrease aerosol generation.
- To improve safety for healthcare staff managing COVID-19 patients requiring tracheostomy.
Main Methods:
- A modified PT technique was employed, utilizing a smaller endotracheal tube (ETT).
- The ETT was specifically cuffed at the carina during the procedure.
Main Results:
- The modified PT technique was successfully implemented in three critically ill COVID-19 patients.
- The procedure demonstrated feasibility in managing these high-risk patients.
Conclusions:
- A modified PT technique, involving a smaller ETT cuffed at the carina and fiber-optic bronchoscopy, offers improved airway management.
- This approach enhances respiratory function, patient comfort, and significantly increases staff safety in critically ill COVID-19 patients.
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