Surgical tracheostomies in COVID-19 patients: A multidisciplinary approach and lessons learned
- PMID: 32389538
- PMCID: PMC7196417
- DOI: 10.1016/j.oraloncology.2020.104767
Surgical tracheostomies in COVID-19 patients: A multidisciplinary approach and lessons learned
Abstract
Surgical tracheostomies have a role in the weaning process of COVID-19 patients treated in intensive care units. A multidisciplinary team approach (MDT) is required for decision making. This process is augmented by specific standard operating practices implemented by senior clinicians. Here, we report on our early experience and outcomes with open tracheostomies in a cohort of COVID-19 patients. We outline the criteria that guide decision making and explore the challenges faced by our intensive care colleagues in the management of these patients. The cohort was 100% male with 90% of them having a raised Body Mass Index (BMI) and other comorbidities (hypertension and diabetes). 60% have been decannulated and have been stepped down the intensive care unit. We recorded no surgical complications or adverse events. The service to date has been shown to be effective, safe, largely reproducible and reflective.
Keywords: 5Ts; CORONA; COVID-19; Intensive care; MDT; Maxillofacial; SARS; Tracheostomy.
Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.
Conflict of interest statement
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Comment on
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CORONA-steps for tracheotomy in COVID-19 patients: A staff-safe method for airway management.Oral Oncol. 2020 Jun;105:104682. doi: 10.1016/j.oraloncology.2020.104682. Epub 2020 Apr 6. Oral Oncol. 2020. PMID: 32278111 Free PMC article.
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Surgical tracheostomies in Covid-19 patients: important considerations and the "5Ts" of safety.Br J Oral Maxillofac Surg. 2020 Jun;58(5):585-589. doi: 10.1016/j.bjoms.2020.04.008. Epub 2020 Apr 16. Br J Oral Maxillofac Surg. 2020. PMID: 32321662 Free PMC article.
References
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- Tay J.K., Khoo M.L.-C., Loh W.S. Surgical considerations for tracheostomy during the COVID-19 pandemic: lessons learned from the severe acute respiratory syndrome outbreak. JAMA Otolaryngol-Head Neck Surgery. 2020 - PubMed
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