Related Experiment Video

Updated: Aug 11, 2025

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
04:46

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation

Published on: January 17, 2011

21.6K

Cricotracheostomy for patients with severe COVID-19: A case control study

Naoki Mukai1, Masahiro Okada2, Saki Konishi1

  • 1Department of Emergency and Critical Care Medicine, Ehime University Graduate School of Medicine, Toon, Japan.

Frontiers in Surgery
|February 3, 2023
PubMed

Insights

Cricotracheostomy is a safe and effective airway procedure for severe coronavirus disease-2019 (COVID-19) patients, including those with obesity and on anticoagulants. This modified tracheostomy technique showed comparable safety to traditional methods with less stomal granulation.

Area of Science:

  • Otolaryngology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Tracheostomy is crucial for severe coronavirus disease-2019 (COVID-19) management.
  • Factors like older age, obesity, and anticoagulant use increase tracheostomy risk in COVID-19 patients.
  • Cricotracheostomy, a modified airway procedure, is beneficial for challenging anatomy and bleeding tendencies.

Purpose of the Study:

  • To evaluate the safety and usefulness of cricotracheostomy in severe COVID-19 patients.
  • To compare cricotracheostomy outcomes in COVID-19 patients with traditional tracheostomy in non-COVID-19 respiratory failure patients.

Main Methods:

  • A retrospective study included 15 severe COVID-19 patients undergoing cricotracheostomy and 40 non-COVID-19 patients undergoing traditional tracheostomy.
  • Data collected included demographics, intubation-to-tracheostomy interval, anticoagulant use, and tracheostomy complications.
  • Follow-up was at least 14 days for the cricotracheostomy group.

Main Results:

  • The COVID-19 group had significantly higher body mass index and anticoagulant use compared to the control group.
  • No significant differences were observed in peri-operative bleeding, subcutaneous emphysema, or stomal infection rates.
  • Stomal granulation was significantly lower in the COVID-19/cricotracheostomy group (P=0.04).

Conclusions:

  • Cricotracheostomy is a safe procedure for managing severe COVID-19 patients requiring airway intervention.
  • The technique demonstrates comparable safety to traditional tracheostomy, with a notable reduction in stomal granulation.
  • This modified approach is particularly useful in COVID-19 patients with risk factors like obesity and anticoagulant use.
Abstract

Keywords:
COVID-19SARS-CoV-2cricoid cartilagedecannulationtracheostomy

More Related Videos

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient07:16

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient

Published on: November 30, 2022

3.4K
The Rigid Tube as an Alternative in Controlling the Problematic Airway08:26

The Rigid Tube as an Alternative in Controlling the Problematic Airway

Published on: June 6, 2020

6.5K

Related Concept Videos

Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
869
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
43
Tracheostomy Decannulation01:21

Tracheostomy Decannulation

Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
314
Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
303
Tracheostomy Care II: Procedure01:25

Tracheostomy Care II: Procedure

Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
301
Oxygen Delivering System III: Tracheostomy and T-piece01:23

Oxygen Delivering System III: Tracheostomy and T-piece

Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
1.7K