Tracheostomy, ventilatory wean, and decannulation in COVID-19 patients.


Journal

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937

Informations de publication

Date de publication:
May 2021
Historique:
received: 28 05 2020
accepted: 03 07 2020
pubmed: 3 8 2020
medline: 24 4 2021
entrez: 3 8 2020
Statut: ppublish

Résumé

COVID-19 patients requiring mechanical ventilation can overwhelm existing bed capacity. We aimed to better understand the factors that influence the trajectory of tracheostomy care in this population to facilitate capacity planning and improve outcomes. We conducted an observational cohort study of patients in a high-volume centre in the worst-affected region of the UK including all patients that underwent tracheostomy for COVID-19 pneumonitis ventilatory wean from 1st March 2020 to 10th May 2020. The primary outcome was time from insertion to decannulation. The analysis utilised Cox regression to account for patients that are still progressing through their tracheostomy pathway. At the point of analysis, a median 21 days (IQR 15-28) post-tracheostomy and 39 days (IQR 32-45) post-intubation, 35/69 (57.4%) patients had been decannulated a median of 17 days (IQR 12-20.5) post-insertion. The overall median age was 55 (IQR 48-61) with a male-to-female ratio of 2:1. In Cox regression analysis, FiO Higher FiO

Identifiants

pubmed: 32740720
doi: 10.1007/s00405-020-06187-1
pii: 10.1007/s00405-020-06187-1
pmc: PMC7395208
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1595-1604

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Auteurs

Chrysostomos Tornari (C)

Department of ENT - Head & Neck Surgery, Guy's & St Thomas' NHS Foundation Trust, London, UK. t.tornari@gmail.com.

Pavol Surda (P)

Department of ENT - Head & Neck Surgery, Guy's & St Thomas' NHS Foundation Trust, London, UK.

Arunjit Takhar (A)

Department of ENT - Head & Neck Surgery, Guy's & St Thomas' NHS Foundation Trust, London, UK.

Nikul Amin (N)

Department of ENT - Head & Neck Surgery, Guy's & St Thomas' NHS Foundation Trust, London, UK.

Alison Dinham (A)

Department of Head & Neck Physiotherapy, Guy's & St Thomas' NHS Foundation Trust, London, UK.

Rachel Harding (R)

Department of Head & Neck Physiotherapy, Guy's & St Thomas' NHS Foundation Trust, London, UK.

David A Ranford (DA)

Department of ENT - Head & Neck Surgery, Guy's & St Thomas' NHS Foundation Trust, London, UK.

Sally K Archer (SK)

Department of Speech & Language Therapy, Guy's & St Thomas' NHS Foundation Trust, London, UK.

Duncan Wyncoll (D)

Department of Intensive Care Medicine, Guy's & St Thomas' NHS Foundation Trust, London, UK.

Stephen Tricklebank (S)

Department of Intensive Care Medicine, Guy's & St Thomas' NHS Foundation Trust, London, UK.

Imran Ahmad (I)

Department of Anaesthetics, Guy's & St Thomas' NHS Foundation Trust, London, UK.

Ricard Simo (R)

Department of ENT - Head & Neck Surgery, Guy's & St Thomas' NHS Foundation Trust, London, UK.

Asit Arora (A)

Department of ENT - Head & Neck Surgery, Guy's & St Thomas' NHS Foundation Trust, London, UK.

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