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[Endoscopy-assisted dilatational tracheostomy in patients with COVID-19]

Yu G Starkov1, K V Lukich1, S V Dzhantukhanova1

  • 1Vishnevsky National Medical Research Center for Surgery, Moscow, Russia.

Khirurgiia
|December 10, 2020
PubMed

Insights

Endoscopy-assisted dilatational tracheostomy is a safe and effective procedure for COVID-19 patients requiring prolonged mechanical ventilation. This technique offers fewer complications and a lower risk of tracheal strictures, improving patient outcomes.

Area of Science:

  • Critical Care Medicine
  • Surgical Procedures
  • Infectious Diseases

Background:

  • COVID-19 often necessitates prolonged mechanical ventilation in intensive care units.
  • Tracheostomy is a crucial intervention for managing airway and ventilation in critically ill patients.
  • Endoscopic guidance offers enhanced safety and precision during tracheostomy procedures.

Purpose of the Study:

  • To evaluate the safety and efficacy of endoscopy-assisted dilatational tracheostomy in patients with COVID-19.
  • To assess the complication rates and outcomes associated with this technique in a specific patient cohort.
  • To determine the suitability of this procedure for prolonged mechanical ventilation in COVID-19 cases.

Main Methods:

  • A retrospective review of 31 endoscopy-assisted dilatational tracheostomies performed between April 17 and June 10, 2020.
  • Procedures utilized Ciaglia (22 cases) and Griggs (9 cases) techniques under endoscopic visualization.
  • All tracheostomies were performed electively in the intensive care unit.

Main Results:

  • Tracheostomy was performed in 19.8% of ICU patients or 36.9% of mechanically ventilated patients within 6.5 days.
  • Survival rate for tracheostomy patients (70.9%) was comparable to non-ventilated patients (79.7%) and higher than ventilated patients without tracheostomy (65.4%).
  • No intraoperative complications were reported during any of the procedures.

Conclusions:

  • Endoscopy-assisted dilatational tracheostomy is a preferred method for prolonged mechanical ventilation, including in COVID-19 patients.
  • Key advantages include reduced intraoperative complications due to endoscopic control.
  • This technique also presents a lower risk of developing tracheal strictures post-procedure.
Abstract

Keywords:
2019-nCoVCOVID-19MERSSARSSARS-CoV-2coronavirusdilatational tracheostomyendoscopic tracheostomy

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