Tracheostomy Timing and Outcome in Severe COVID-19: The WeanTrach Multicenter Study.
COVID-19
SARS-CoV-2
coronavirus
intensive care
percutaneous
surgical technique
tracheostomy
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
16 Jun 2021
16 Jun 2021
Historique:
received:
29
04
2021
revised:
10
06
2021
accepted:
10
06
2021
entrez:
2
7
2021
pubmed:
3
7
2021
medline:
3
7
2021
Statut:
epublish
Résumé
Tracheostomy can be performed safely in patients with coronavirus disease 2019 (COVID-19). However, little is known about the optimal timing, effects on outcome, and complications. A multicenter, retrospective, observational study. This study included 153 tracheostomized COVID-19 patients from 11 intensive care units (ICUs). The primary endpoint was the median time to tracheostomy in critically ill COVID-19 patients. Secondary endpoints were survival rate, length of ICU stay, and post-tracheostomy complications, stratified by tracheostomy timing (early versus late) and technique (surgical versus percutaneous). The median time to tracheostomy was 15 (1-64) days. There was no significant difference in survival between critically ill COVID-19 patients who received tracheostomy before versus after day 15, nor between surgical and percutaneous techniques. ICU length of stay was shorter with early compared to late tracheostomy ( Among critically ill patients with COVID-19, neither early nor percutaneous tracheostomy improved outcomes, but did shorten ICU stay. Infectious complications were less frequent with percutaneous than surgical tracheostomy.
Sections du résumé
BACKGROUND
BACKGROUND
Tracheostomy can be performed safely in patients with coronavirus disease 2019 (COVID-19). However, little is known about the optimal timing, effects on outcome, and complications.
METHODS
METHODS
A multicenter, retrospective, observational study. This study included 153 tracheostomized COVID-19 patients from 11 intensive care units (ICUs). The primary endpoint was the median time to tracheostomy in critically ill COVID-19 patients. Secondary endpoints were survival rate, length of ICU stay, and post-tracheostomy complications, stratified by tracheostomy timing (early versus late) and technique (surgical versus percutaneous).
RESULTS
RESULTS
The median time to tracheostomy was 15 (1-64) days. There was no significant difference in survival between critically ill COVID-19 patients who received tracheostomy before versus after day 15, nor between surgical and percutaneous techniques. ICU length of stay was shorter with early compared to late tracheostomy (
CONCLUSIONS
CONCLUSIONS
Among critically ill patients with COVID-19, neither early nor percutaneous tracheostomy improved outcomes, but did shorten ICU stay. Infectious complications were less frequent with percutaneous than surgical tracheostomy.
Identifiants
pubmed: 34208672
pii: jcm10122651
doi: 10.3390/jcm10122651
pmc: PMC8235219
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Brazilian Council for Scientific and Technological Development (COVID-19-CNPq) 401700/2020-8 and 403485/2020-7, the Rio de Janeiro State Research Foundation (COVID-19-FAPERJ) E-26/210.181/2020, the Funding Authority for Studies and Projects (FINEP) 012000
ID : 401700/2020-8 and 403485/2020-7
Références
Int J Oral Maxillofac Surg. 2020 Nov;49(11):1385-1391
pubmed: 32912655
Lancet Respir Med. 2015 Feb;3(2):150-158
pubmed: 25680911
Ann Thorac Surg. 2020 Sep;110(3):1006-1011
pubmed: 32339508
Lancet Respir Med. 2020 Jul;8(7):717-725
pubmed: 32422180
JAMA Otolaryngol Head Neck Surg. 2020 Oct 1;146(10):887-888
pubmed: 32880624
Crit Care. 2014 Dec 19;18(6):544
pubmed: 25526983
Crit Care. 2006;10(2):R55
pubmed: 16606435
Am J Crit Care. 2014 Nov;23(6):e80-7
pubmed: 25362678
BMJ. 2005 May 28;330(7502):1243
pubmed: 15901643
Eur Arch Otorhinolaryngol. 2021 Jun;278(6):2107-2114
pubmed: 33420842
Ann Surg. 2020 Sep 1;272(3):e181-e186
pubmed: 32541213
Front Med (Lausanne). 2020 Dec 17;7:615845
pubmed: 33425960
JAMA. 2020 Apr 28;323(16):1574-1581
pubmed: 32250385
Crit Care. 2015 Dec 04;19:424
pubmed: 26635016
Clin Microbiol Infect. 2020 Nov;26(11):1537-1544
pubmed: 32810610
JAMA Otolaryngol Head Neck Surg. 2021 Mar 1;147(3):239-244
pubmed: 33331855
Crit Care. 2021 Apr 22;25(1):155
pubmed: 33888132
JAMA. 2016 Feb 23;315(8):788-800
pubmed: 26903337
Am J Crit Care. 2020 Nov 1;29(6):e116-e127
pubmed: 32929453
JAMA. 2010 Apr 21;303(15):1483-9
pubmed: 20407057
Otolaryngol Head Neck Surg. 2021 Jun;164(6):1136-1147
pubmed: 33138722
PLoS One. 2020 Sep 30;15(9):e0240014
pubmed: 32997704
Crit Care Med. 2005 May;33(5):1015-20
pubmed: 15891330
Eur Arch Otorhinolaryngol. 2020 Jul;277(7):2133-2135
pubmed: 32322959
Auris Nasus Larynx. 2021 Jun;48(3):511-517
pubmed: 33143935
Head Neck. 2020 Jun;42(6):1259-1267
pubmed: 32270581
Crit Care Med. 2006 Aug;34(8):2145-52
pubmed: 16775568
Laryngoscope. 2001 Mar;111(3):494-500
pubmed: 11224782
Crit Care Med. 2021 Feb 1;49(2):261-270
pubmed: 33201005
JAMA Otolaryngol Head Neck Surg. 2020 Jun 1;146(6):579-584
pubmed: 32232423
Br J Anaesth. 2020 Dec;125(6):872-879
pubmed: 32988602
Intensive Care Med. 2008 Oct;34(10):1779-87
pubmed: 18592210
J Intensive Care. 2018 Jan 4;6:1
pubmed: 29308208
JAMA. 2013 May 22;309(20):2121-9
pubmed: 23695482
Expert Rev Respir Med. 2020 Sep;14(9):865-868
pubmed: 32567404
Crit Care Clin. 2017 Apr;33(2):311-322
pubmed: 28284297
Clin Respir J. 2016 Nov;10(6):684-692
pubmed: 25763477
Am J Otolaryngol. 2021 Mar-Apr;42(2):102867
pubmed: 33422946
Otolaryngol Head Neck Surg. 2020 Jul;163(1):135-137
pubmed: 32396455
Ann Intern Med. 2011 Mar 15;154(6):373-83
pubmed: 21403073
Intensive Care Med. 2019 Nov;45(11):1619-1621
pubmed: 31451858
J Clin Med. 2021 Jan 03;10(1):
pubmed: 33401632
Lung. 2019 Jun;197(3):267-275
pubmed: 31020401