Revised recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic – what a difference a year makes
Abstract Background During the early part of the COVID-19 pandemic, the Canadian Society of Otolaryngology - Head & Neck Surgery (CSO-HNS) task force published recommendations on performance of tracheotomy. Since then, our understanding of the virus has evolved with ongoing intensive research ef...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-10-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40463-021-00531-z |
| _version_ | 1797970735281471488 |
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| author | D. D. Sommer D. Cote T. McHugh M. Corsten M. A. Tewfik S. Khalili K. Fung M. Gupta N. Sne P. T. Engels E. Weitzel T. F. E. Brown J. Paul K. M. Kost J. A. Anderson L. Sowerby D. Mertz I. J. Witterick |
| author_facet | D. D. Sommer D. Cote T. McHugh M. Corsten M. A. Tewfik S. Khalili K. Fung M. Gupta N. Sne P. T. Engels E. Weitzel T. F. E. Brown J. Paul K. M. Kost J. A. Anderson L. Sowerby D. Mertz I. J. Witterick |
| author_sort | D. D. Sommer |
| collection | DOAJ |
| description | Abstract Background During the early part of the COVID-19 pandemic, the Canadian Society of Otolaryngology - Head & Neck Surgery (CSO-HNS) task force published recommendations on performance of tracheotomy. Since then, our understanding of the virus has evolved with ongoing intensive research efforts. New literature has helped us better understand various aspects including patient outcomes and health care worker (HCW) risks associated with tracheotomy during the COVID-19 pandemic. Accordingly, the task force has re-evaluated and revised some of the previous recommendations. Main body Based on recent evidence, a negative reverse transcription polymerase chain reaction (RT-PCR) COVID-19 swab status is no longer the main deciding factor in the timing of tracheotomy. Instead, tracheotomy may be considered as soon as COVID-19 swab positive patients are greater than 20 days beyond initial symptoms and 2 weeks of mechanical ventilation. Furthermore, both open and percutaneous surgical techniques may be considered with both techniques showing similar safety and outcome profiles. Additional recommendations with discussion of current evidence are presented. Conclusion These revised recommendations apply new evidence in optimizing patient and health care system outcomes as well as minimizing risks of COVID-19 transmission during aerosol-generating tracheotomy procedures. As previously noted, additional evidence may lead to further evolution of these and other similar recommendations. Graphical abstract |
| first_indexed | 2024-04-11T03:21:44Z |
| format | Article |
| id | doaj.art-a9cd955a2821459d932b9f8b0352592a |
| institution | Directory Open Access Journal |
| issn | 1916-0216 |
| language | English |
| last_indexed | 2024-04-11T03:21:44Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj.art-a9cd955a2821459d932b9f8b0352592a2023-01-02T08:55:58ZengBMCJournal of Otolaryngology - Head and Neck Surgery1916-02162021-10-015011510.1186/s40463-021-00531-zRevised recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic – what a difference a year makesD. D. Sommer0D. Cote1T. McHugh2M. Corsten3M. A. Tewfik4S. Khalili5K. Fung6M. Gupta7N. Sne8P. T. Engels9E. Weitzel10T. F. E. Brown11J. Paul12K. M. Kost13J. A. Anderson14L. Sowerby15D. Mertz16I. J. Witterick17Division of Otolaryngology - Head & Neck Surgery - Department of Surgery, McMaster UniversityDivision of Otolaryngology - Head and Neck Surgery, University of AlbertaDivision of Otolaryngology - Head & Neck Surgery - Department of Surgery, McMaster UniversityDivision of Otolaryngology - Head & Neck Surgery, Dalhousie UniversityDepartment of Otolaryngology - Head and Neck Surgery, McGill UniversityAurora Neuroscience Innovation InstituteDepartment of Otolaryngology - Head and Neck Surgery, Western UniversityDivision of Otolaryngology - Head & Neck Surgery - Department of Surgery, McMaster UniversityDepartment of Surgery and Critical Care, McMaster UniversityDepartment of Surgery and Critical Care, McMaster UniversityDepartment of Otolaryngology Head and Neck Surgery, Lackland Air Force Base, Wilford Hall Medical CenterDivision of Otolaryngology - Head & Neck Surgery, Dalhousie UniversityDepartment of Anesthesia, McMaster UniversityDepartment of Otolaryngology - Head and Neck Surgery, McGill UniversityDepartment of Otolaryngology - Head & Neck Surgery, University of TorontoDepartment of Otolaryngology - Head and Neck Surgery, Western UniversityDivision of Infectious Disease, Department of Medicine, McMaster UniversityDepartment of Otolaryngology - Head & Neck Surgery, University of TorontoAbstract Background During the early part of the COVID-19 pandemic, the Canadian Society of Otolaryngology - Head & Neck Surgery (CSO-HNS) task force published recommendations on performance of tracheotomy. Since then, our understanding of the virus has evolved with ongoing intensive research efforts. New literature has helped us better understand various aspects including patient outcomes and health care worker (HCW) risks associated with tracheotomy during the COVID-19 pandemic. Accordingly, the task force has re-evaluated and revised some of the previous recommendations. Main body Based on recent evidence, a negative reverse transcription polymerase chain reaction (RT-PCR) COVID-19 swab status is no longer the main deciding factor in the timing of tracheotomy. Instead, tracheotomy may be considered as soon as COVID-19 swab positive patients are greater than 20 days beyond initial symptoms and 2 weeks of mechanical ventilation. Furthermore, both open and percutaneous surgical techniques may be considered with both techniques showing similar safety and outcome profiles. Additional recommendations with discussion of current evidence are presented. Conclusion These revised recommendations apply new evidence in optimizing patient and health care system outcomes as well as minimizing risks of COVID-19 transmission during aerosol-generating tracheotomy procedures. As previously noted, additional evidence may lead to further evolution of these and other similar recommendations. Graphical abstracthttps://doi.org/10.1186/s40463-021-00531-zTracheotomyTracheostomyCOVID-19SARS-CoV-2CoronavirusIntensive Care Unit/ICU |
| spellingShingle | D. D. Sommer D. Cote T. McHugh M. Corsten M. A. Tewfik S. Khalili K. Fung M. Gupta N. Sne P. T. Engels E. Weitzel T. F. E. Brown J. Paul K. M. Kost J. A. Anderson L. Sowerby D. Mertz I. J. Witterick Revised recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic – what a difference a year makes Journal of Otolaryngology - Head and Neck Surgery Tracheotomy Tracheostomy COVID-19 SARS-CoV-2 Coronavirus Intensive Care Unit/ICU |
| title | Revised recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic – what a difference a year makes |
| title_full | Revised recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic – what a difference a year makes |
| title_fullStr | Revised recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic – what a difference a year makes |
| title_full_unstemmed | Revised recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic – what a difference a year makes |
| title_short | Revised recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic – what a difference a year makes |
| title_sort | revised recommendations from the cso hns taskforce on performance of tracheotomy during the covid 19 pandemic what a difference a year makes |
| topic | Tracheotomy Tracheostomy COVID-19 SARS-CoV-2 Coronavirus Intensive Care Unit/ICU |
| url | https://doi.org/10.1186/s40463-021-00531-z |
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