RT Journal Article
SR Electronic
T1 Modified percutaneous tracheostomy in patients with COVID-19
JF Trauma Surgery & Acute Care Open
JO Trauma Surg Acute Care Open
FD BMJ Publishing Group Ltd
SP e000625
DO 10.1136/tsaco-2020-000625
VO 5
IS 1
A1 Beatrice J Sun
A1 Christopher J Wolff
A1 Hannah M Bechtold
A1 Dwayne Free
A1 Javier Lorenzo
A1 Patrick R Minot
A1 Paul G Maggio
A1 David A Spain
A1 Thomas G Weiser
A1 Joseph D Forrester
YR 2020
UL http://tsaco.bmj.com/content/5/1/e000625.abstract
AB Background Patients hospitalized with COVID-19 are at risk of developing hypoxic respiratory failure and often require prolonged mechanical ventilation. Indication and timing to perform tracheostomy is controversial in patients with COVID-19.Methods This was a single-institution retrospective review of tracheostomies performed on patients admitted for COVID-19 between April 8, 2020 and August 1, 2020 using a modified percutaneous tracheostomy technique to minimize hypoxia and aerosolization.Results Twelve tracheostomies were performed for COVID-related respiratory failure. Median patient age was 54 years (range: 36–76) and 9 (75%) were male. Median time to tracheostomy was 17 days (range: 10–27), and 5 (42%) patients had failed attempts at extubation prior to tracheostomy. There were no intraprocedural complications, including hypoxia. Post-tracheostomy bleeding was noted in two patients. Eight (67%) patients have been discharged at the time of this study, and there were four patient deaths unrelated to tracheostomy placement. No healthcare worker transmissions resulted from participating in the tracheostomy procedure.Conclusions A modified percutaneous tracheostomy is feasible and can be safely performed in patients infected with COVID-19.Level of evidence Level V, case series.