Tracheostomy for COVID-19: evolving best practice

Abstract

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2021. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2021 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901 .

Fig. 1

Typical clinical course, viral polymerase chain reaction (PCR), and antiviral antibody detection and infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The transparent red box shows the suggested window for tracheostomy, on ICU days 10–21, which corresponds with 16–30 days from symptom onset. The solid bars and curves represent the proportion of all cases. Time zero is symptom onset (the x-axis is not to scale). Adapted from [19] with permission

Fig. 2

Factors favoring early or late tracheostomy in patients with COVID-19 disease. Patient factors (blue), staff factors (paler blue) and critical care resource factors (brown). Adapted from [19] (with permission)

Fig. 3

Balancing the benefit to the patient versus the risk to the staff

Fig. 4

Patient-focused outcomes in tracheostomy care (the patient provided permission to publish the photo)