Safety of bedside surgical tracheostomy during COVID-19 pandemic: A retrospective observational study
Data regarding safety of bedside surgical tracheostomy in novel coronavirus 2019 (COVID-19) mechanically ventilated patients admitted to the intensive care unit (ICU) are lacking. We performed this study to assess the safety of bedside surgical tracheostomy in COVID-19 patients admitted to ICU. This...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526872/?tool=EBI |
| _version_ | 1828820658862161920 |
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| author | Edoardo Picetti Anna Fornaciari Fabio Silvio Taccone Laura Malchiodi Silvia Grossi Filippo Di Lella Maurizio Falcioni Giulia D’Angelo Emanuele Sani Sandra Rossi Corstiaan den Uil |
| author_facet | Edoardo Picetti Anna Fornaciari Fabio Silvio Taccone Laura Malchiodi Silvia Grossi Filippo Di Lella Maurizio Falcioni Giulia D’Angelo Emanuele Sani Sandra Rossi Corstiaan den Uil |
| author_sort | Edoardo Picetti |
| collection | DOAJ |
| description | Data regarding safety of bedside surgical tracheostomy in novel coronavirus 2019 (COVID-19) mechanically ventilated patients admitted to the intensive care unit (ICU) are lacking. We performed this study to assess the safety of bedside surgical tracheostomy in COVID-19 patients admitted to ICU. This retrospective, single-center, cohort observational study (conducted between February, 23 and April, 30, 2020) was performed in our 45-bed dedicated COVID-19 ICU. Inclusion criteria were: a) age over 18 years; b) confirmed diagnosis of COVID-19 infection (with nasopharyngeal/oropharyngeal swab); c) invasive mechanical ventilation and d) clinical indication for tracheostomy. The objectives of this study were to describe: 1) perioperative complications, 2) perioperative alterations in respiratory gas exchange and 3) occurrence of COVID-19 infection among health-care providers involved into the procedure. A total of 125 COVID-19 patients were admitted to the ICU during the study period. Of those, 66 (53%) underwent tracheostomy. Tracheostomy was performed after a mean of 6.1 (± 2.1) days since ICU admission. Most of tracheostomies (47/66, 71%) were performed by intensivists and the mean time of the procedure was 22 (± 4.4) minutes. No intraprocedural complications was reported. Stoma infection and bleeding were reported in 2 patients and 7 patients, respectively, in the post-procedure period, without significant clinical consequences. The mean PaO2 / FiO2 was significantly lower at the end of tracheostomy (117.6 ± 35.4) then at the beginning (133.4 ± 39.2) or 24 hours before (135.8 ± 51.3) the procedure. However, PaO2/FiO2 progressively increased at 24 hours after tracheostomy (142 ± 50.7). None of the members involved in the tracheotomy procedures developed COVID-19 infection. Bedside surgical tracheostomy appears to be feasible and safe, both for patients and for health care workers, during COVID-19 pandemic in an experienced center. |
| first_indexed | 2024-12-12T12:38:13Z |
| format | Article |
| id | doaj.art-d2f1ba9599994f33ac575edd10e2170c |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T12:38:13Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-d2f1ba9599994f33ac575edd10e2170c2022-12-22T00:24:18ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01159Safety of bedside surgical tracheostomy during COVID-19 pandemic: A retrospective observational studyEdoardo PicettiAnna FornaciariFabio Silvio TacconeLaura MalchiodiSilvia GrossiFilippo Di LellaMaurizio FalcioniGiulia D’AngeloEmanuele SaniSandra RossiCorstiaan den UilData regarding safety of bedside surgical tracheostomy in novel coronavirus 2019 (COVID-19) mechanically ventilated patients admitted to the intensive care unit (ICU) are lacking. We performed this study to assess the safety of bedside surgical tracheostomy in COVID-19 patients admitted to ICU. This retrospective, single-center, cohort observational study (conducted between February, 23 and April, 30, 2020) was performed in our 45-bed dedicated COVID-19 ICU. Inclusion criteria were: a) age over 18 years; b) confirmed diagnosis of COVID-19 infection (with nasopharyngeal/oropharyngeal swab); c) invasive mechanical ventilation and d) clinical indication for tracheostomy. The objectives of this study were to describe: 1) perioperative complications, 2) perioperative alterations in respiratory gas exchange and 3) occurrence of COVID-19 infection among health-care providers involved into the procedure. A total of 125 COVID-19 patients were admitted to the ICU during the study period. Of those, 66 (53%) underwent tracheostomy. Tracheostomy was performed after a mean of 6.1 (± 2.1) days since ICU admission. Most of tracheostomies (47/66, 71%) were performed by intensivists and the mean time of the procedure was 22 (± 4.4) minutes. No intraprocedural complications was reported. Stoma infection and bleeding were reported in 2 patients and 7 patients, respectively, in the post-procedure period, without significant clinical consequences. The mean PaO2 / FiO2 was significantly lower at the end of tracheostomy (117.6 ± 35.4) then at the beginning (133.4 ± 39.2) or 24 hours before (135.8 ± 51.3) the procedure. However, PaO2/FiO2 progressively increased at 24 hours after tracheostomy (142 ± 50.7). None of the members involved in the tracheotomy procedures developed COVID-19 infection. Bedside surgical tracheostomy appears to be feasible and safe, both for patients and for health care workers, during COVID-19 pandemic in an experienced center.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526872/?tool=EBI |
| spellingShingle | Edoardo Picetti Anna Fornaciari Fabio Silvio Taccone Laura Malchiodi Silvia Grossi Filippo Di Lella Maurizio Falcioni Giulia D’Angelo Emanuele Sani Sandra Rossi Corstiaan den Uil Safety of bedside surgical tracheostomy during COVID-19 pandemic: A retrospective observational study PLoS ONE |
| title | Safety of bedside surgical tracheostomy during COVID-19 pandemic: A retrospective observational study |
| title_full | Safety of bedside surgical tracheostomy during COVID-19 pandemic: A retrospective observational study |
| title_fullStr | Safety of bedside surgical tracheostomy during COVID-19 pandemic: A retrospective observational study |
| title_full_unstemmed | Safety of bedside surgical tracheostomy during COVID-19 pandemic: A retrospective observational study |
| title_short | Safety of bedside surgical tracheostomy during COVID-19 pandemic: A retrospective observational study |
| title_sort | safety of bedside surgical tracheostomy during covid 19 pandemic a retrospective observational study |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526872/?tool=EBI |
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