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Modified percutaneous tracheostomy in patients with COVID-19
Beatrice J Sun1, Christopher J Wolff1, Hannah M Bechtold2
1Department of Surgery, Stanford University, Stanford, California, USA.
Trauma Surgery & Acute Care Open
|June 30, 2021
Summary
A modified percutaneous tracheostomy is a safe and feasible procedure for patients with COVID-19 requiring mechanical ventilation. This technique minimizes hypoxia and aerosolization, with no reported healthcare worker infections.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Surgical Procedures
Background:
- COVID-19 patients face risks of hypoxic respiratory failure and prolonged mechanical ventilation.
- The optimal timing and indication for tracheostomy in COVID-19 patients remain debated.
- Tracheostomy may be necessary for managing severe respiratory distress in COVID-19.
Purpose of the Study:
- To evaluate the feasibility and safety of a modified percutaneous tracheostomy technique in COVID-19 patients.
- To assess complications and outcomes associated with tracheostomy in this population.
- To determine the impact of the procedure on healthcare worker safety.
Main Methods:
- Retrospective review of tracheostomies performed on COVID-19 patients.
- Utilized a modified percutaneous tracheostomy technique to reduce hypoxia and aerosolization.
- Procedure performed at a single institution between April 2020 and August 2020.
Main Results:
- Twelve tracheostomies were performed for COVID-related respiratory failure.
- No intraprocedural hypoxia or complications were observed; two cases of post-tracheostomy bleeding occurred.
- Eight patients were discharged, four deaths occurred unrelated to tracheostomy, and no healthcare worker transmissions were reported.
Conclusions:
- Modified percutaneous tracheostomy is a safe and feasible option for COVID-19 patients.
- The technique effectively minimizes risks of hypoxia and aerosolization.
- Tracheostomy can be safely performed without adverse effects on healthcare workers.
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