Surgical tracheotomy in COVID-19 patients: an Italian single centre experience.


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:
Nov 2021
Historique:
received: 27 12 2020
accepted: 09 02 2021
pubmed: 23 2 2021
medline: 6 10 2021
entrez: 22 2 2021
Statut: ppublish

Résumé

Coronavirus infection disease 2019 (COVID-19) causes in 10% of patients a severe respiratory distress syndrome managed with invasive mechanical ventilation (IMV), sometimes difficult to wean. The role of tracheotomy is debated for the possible risks for patients and staff. We are going to describe here our experience with surgical tracheotomy in COVID-19 positive patients. We enrolled all intensive care unit (ICU) patients requiring longer than 10 days of IMV. Demographic, clinical, respiratory, complications, and outcomes data were collected, in a particular length of weaning from sedation and IMV, in-ICU and in-hospital mortality rate. All healthcare operators involved were tested for SARS-CoV2 by pharyngeal swab and blood test (antibody test). 13 out of 68 ICU patients (19.1%) underwent surgical tracheotomy after a median intubation period of 14 days. The mean age was 60 (56-65) years. 85% were male patients. Postoperative mild bleeding was seen in 30.7%, pneumothorax in 7.7%. Mean weaning from sedation required 3 days, 19 days from IMV. In-ICU and in-hospital COVID-infection-related mortality was 23.1% and 30.7%, respectively. None of the healthcare operators was found SARS-CoV2 positive during the period of the study. In COVID-19 pandemic surgical tracheotomy enables to wean from sedation and subsequently from IMV in a safe way for both patients and personnel.

Identifiants

pubmed: 33616747
doi: 10.1007/s00405-021-06697-6
pii: 10.1007/s00405-021-06697-6
pmc: PMC7897727
doi:

Substances chimiques

RNA, Viral 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

4501-4507

Informations de copyright

© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.

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Auteurs

Roberto Briatore (R)

Department of Otorhinolaryngology, "Cardinal Massaia" Hospital, Corso Dante Alighieri, 202, 14100, Asti, AT, Italy.

Federico Aprile (F)

Department of Otorhinolaryngology, "Cardinal Massaia" Hospital, Corso Dante Alighieri, 202, 14100, Asti, AT, Italy. federico.aprile89@gmail.com.

Agostino Roasio (A)

Department of Anesthesia and Intensive Care, "Cardinal Massaia" Hospital, Asti, Italy.

Alessandro Bianchi (A)

Department of Anesthesia and Intensive Care, "Cardinal Massaia" Hospital, Asti, Italy.

Stefano Bosso (S)

Department of Anesthesia and Intensive Care, "Cardinal Massaia" Hospital, Asti, Italy.

Livio Carmino (L)

Department of Anesthesia and Intensive Care, "Cardinal Massaia" Hospital, Asti, Italy.

Laura Lorenzelli (L)

Department of Anesthesia and Intensive Care, "Cardinal Massaia" Hospital, Asti, Italy.

Martina Scanu (M)

Department of Anesthesia and Intensive Care, "Cardinal Massaia" Hospital, Asti, Italy.

Mattia Zanin (M)

Department of Anesthesia and Intensive Care, "Cardinal Massaia" Hospital, Asti, Italy.

Giuseppina Bosso (G)

Operating Room Service, "Cardinal Massaia" Hospital, Asti, Italy.

Vincenzo Torchia (V)

Operating Room Service, "Cardinal Massaia" Hospital, Asti, Italy.

Paolo Pisani (P)

Department of Otorhinolaryngology, "Cardinal Massaia" Hospital, Corso Dante Alighieri, 202, 14100, Asti, AT, Italy.

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