Percutaneous dilatational tracheostomy for saturating influx of COVID-19 patients: Experience of military ENT physicians deployed in Mulhouse, France.


Journal

European annals of otorhinolaryngology, head and neck diseases
ISSN: 1879-730X
Titre abrégé: Eur Ann Otorhinolaryngol Head Neck Dis
Pays: France
ID NLM: 101531465

Informations de publication

Date de publication:
Sep 2020
Historique:
pubmed: 8 7 2020
medline: 12 9 2020
entrez: 8 7 2020
Statut: ppublish

Résumé

The main objective was to demonstrate the feasibility of percutaneous tracheostomy performed under difficult conditions by military ENT physicians during their deployment in the military intensive care field hospital of the French Military Medical Service in Mulhouse to confront the exceptional COVID-19 pandemic. The secondary objective was to assess reliability and safety for patient and caregivers, with a risk of iatrogenic viral contamination. A single-center retrospective study was conducted between March 25 and April 25, 2020, in 47 COVID-19 patients requiring prolonged mechanical ventilation. The inclusion criterion was having undergone percutaneous tracheostomy. Eighteen consecutively included patients had successfully undergone percutaneous tracheostomy despite unfavorable anatomical conditions (short neck: 83.3%, overweight or obese: 88.9%). Median time to completion was 11 days after intubation, with an average duration of 7minutes. The procedure was technically compliant in 83.3% of cases, and considered easy (on self-assessment) in 72.2%, with 2 minor per-procedural complications. No crossover to surgery was required. There was only 1 major post-procedural complication (late hemorrhage). This study showed the feasibility of percutaneous tracheostomy by an ENT physician under COVID-19 biohazard conditions. The technique was fast, easy and safe and met safety requirements for patient and staff.

Identifiants

pubmed: 32631724
pii: S1879-7296(20)30156-3
doi: 10.1016/j.anorl.2020.06.016
pmc: PMC7321049
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

263-268

Informations de copyright

Copyright © 2020. Published by Elsevier Masson SAS.

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Auteurs

J-B Morvan (JB)

Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France; Elément Militaire de Réanimation du Service de Santé des Armées EMRSSA, Mulhouse, France. Electronic address: jbmorvan@hotmail.com.

D Rivière (D)

Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France; Elément Militaire de Réanimation du Service de Santé des Armées EMRSSA, Mulhouse, France.

M Danguy des Déserts (M)

Elément Militaire de Réanimation du Service de Santé des Armées EMRSSA, Mulhouse, France; Service d'Anesthésie-Réanimation, Hôpital d'Instruction des Armées Clermont Tonnerre, Brest, France.

G Bonfort (G)

Elément Militaire de Réanimation du Service de Santé des Armées EMRSSA, Mulhouse, France; Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital d'Instruction des Armées Legouest, Metz, France.

Q Mathais (Q)

Elément Militaire de Réanimation du Service de Santé des Armées EMRSSA, Mulhouse, France; Service d'Anesthésie-Réanimation, Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France.

P Pasquier (P)

Elément Militaire de Réanimation du Service de Santé des Armées EMRSSA, Mulhouse, France; Service d'Anesthésie-Réanimation, Hôpital d'Instruction des Armées Percy, Clamart, France; École du Val-de-Grâce, Paris, France.

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