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. 2022 Jul;101(6):354-358.
doi: 10.1177/0145561321993567. Epub 2021 Feb 11.

Outcomes After Tracheostomy for Patients With Respiratory Failure due to COVID-19

John J Cardasis  1 , J K Rasamny  1 , Craig E Berzofsky  1 , Jennifer A Bello  1 , Alan S Multz  1
Affiliations

Outcomes After Tracheostomy for Patients With Respiratory Failure due to COVID-19

John J Cardasis et al. Ear Nose Throat J. 2022 Jul.

Abstract

Objective: To evaluate the utility and safety of tracheostomy for patients with respiratory failure from COIVD-19 and describe patient clinical characteristics and process of management.

Methods: Case series of the first 24 COVID-19 patients who underwent tracheostomy at our institution, a single-center tertiary care community hospital intensive care/ventilator weaning unit. The patients all had respiratory failure from COVID-19 and required endotracheal intubation and mechanical ventilation. Outcomes reviewed include mortality, percent discharged, percent liberated from mechanical ventilation, percent decannulated, time from tracheostomy to ventilator liberation and discharge, and number of staff infected with COVID-19 during tracheostomy and management.

Results: Of the 24 patients who underwent tracheostomy, 21 (88%) of 24 survived. Twenty (83%) were liberated from mechanical ventilation, and 19 (79%) were discharged. Fourteen (74%) of the discharged had been decannulated. The average (± SD) time from tracheostomy to ventilator liberation was 9 ± 4.3 days and from tracheostomy to discharge 21 ± 9 days. All discharged patients had been liberated from mechanical ventilation. No health care workers became infected with COVID-19 during the procedure or subsequent patient management.

Conclusion: Patients with respiratory failure from COVID-19 who underwent tracheostomy had a high likelihood of being liberated from mechanical ventilation and discharged. Tracheostomy and subsequent ventilator weaning management can be performed safely. Tracheostomy allowed for decompression of higher acuity medical units in a safe and effective manner.

Keywords: COVID-19; outcomes; respiratory failure; safety; tracheostomy; ventilator weaning.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Obstructed endotracheal tube due to precipitated secretions.
See this image and copyright information in PMC

References

    1. Ezekiel J, Govind P, Ross U, et al. Fair allocation of scarce medical resources in the time of COVID-19. N EngL J Med. 2020;382(21):2049–2055. - PubMed
    1. Cummings M, Baldwin M, Abrams D, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet. 2020;395(10239):1763–1770. - PMC - PubMed
    1. Argenziano M, Bruce S, Slater C, et al. Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series. BMJ. 2020;369:m1996. - PMC - PubMed
    1. Esteban A, Anzueto A, Alia I, et al. How is mechanical ventilation employed in the intensive care unit? An international utilization review. Am J Respir Crit Care Med. 2000;161(5):1450–1458. - PubMed
    1. Rana S, Pendem S, Pogodzinski M, Hubmayer R, Gajic O. Tracheostomy in critically ill patients. Mayo Clin Proc. 2005;80(12):1632–1638. - PubMed

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