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Tracheostomy is Safe in Patients with Prolonged Intubation After Coronavirus Disease 2019 Infection
BACKGROUND: Tracheostomy improves outcomes for critically ill patients requiring prolonged mechanical ventilation. Data are limited on the use and benefit of tracheostomies for intubated, critically ill coronavirus disease 2019 (COVID-19) patients. During the surge in COVID 19 infections in metropol...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075851/ https://www.ncbi.nlm.nih.gov/pubmed/34087619 http://dx.doi.org/10.1016/j.jss.2021.04.023 |
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author | Goldstein, Carma Deisher, David Gorman, Elizabeth Sheikh, Fariha Sifri, Ziad Glass, Nina E. |
author_facet | Goldstein, Carma Deisher, David Gorman, Elizabeth Sheikh, Fariha Sifri, Ziad Glass, Nina E. |
author_sort | Goldstein, Carma |
collection | PubMed |
description | BACKGROUND: Tracheostomy improves outcomes for critically ill patients requiring prolonged mechanical ventilation. Data are limited on the use and benefit of tracheostomies for intubated, critically ill coronavirus disease 2019 (COVID-19) patients. During the surge in COVID 19 infections in metropolitan New York/New Jersey, our hospital cared for many COVID-19 patients who required prolonged intubation. This study describes the outcomes in COVID-19 patients who underwent tracheostomy. METHODS: We present a case series of patients with COVID-19 who underwent tracheostomy at a single institution. Tracheostomies were performed on patients with prolonged mechanical ventilation beyond 3 wk. Patient demographics, medical comorbidities, and ventilator settings prior to tracheostomy were reviewed. Primary outcome was in-hospital mortality. Secondary outcomes included time on mechanical ventilation, length of ICU and hospital stay, and discharge disposition. RESULTS: Fifteen COVID-19 patients underwent tracheostomy at an average of 31 d post intubation. Two patients (13%) died. Half of our cohort was liberated from the ventilator (8 patients, 53%), with an average time to liberation of 14 ± 6 d after tracheostomy. Among patients off mechanical ventilation, 5 (63%) had their tracheostomies removed prior to discharge. The average intensive care length of stay was 47 ± 13 d (range 29-74 d) and the average hospital stay was 59 ± 16 d (range 34-103 d). CONCLUSIONS: This study reports promising outcomes in COVID-19 patients with acute respiratory failure and need for prolonged ventilation who undergo tracheostomy during their hospitalization. Further research is warranted to establish appropriate indications for tracheostomy in COVID-19 and confirm outcomes. |
format | Online Article Text |
id | pubmed-8075851 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-80758512021-04-27 Tracheostomy is Safe in Patients with Prolonged Intubation After Coronavirus Disease 2019 Infection Goldstein, Carma Deisher, David Gorman, Elizabeth Sheikh, Fariha Sifri, Ziad Glass, Nina E. J Surg Res Article BACKGROUND: Tracheostomy improves outcomes for critically ill patients requiring prolonged mechanical ventilation. Data are limited on the use and benefit of tracheostomies for intubated, critically ill coronavirus disease 2019 (COVID-19) patients. During the surge in COVID 19 infections in metropolitan New York/New Jersey, our hospital cared for many COVID-19 patients who required prolonged intubation. This study describes the outcomes in COVID-19 patients who underwent tracheostomy. METHODS: We present a case series of patients with COVID-19 who underwent tracheostomy at a single institution. Tracheostomies were performed on patients with prolonged mechanical ventilation beyond 3 wk. Patient demographics, medical comorbidities, and ventilator settings prior to tracheostomy were reviewed. Primary outcome was in-hospital mortality. Secondary outcomes included time on mechanical ventilation, length of ICU and hospital stay, and discharge disposition. RESULTS: Fifteen COVID-19 patients underwent tracheostomy at an average of 31 d post intubation. Two patients (13%) died. Half of our cohort was liberated from the ventilator (8 patients, 53%), with an average time to liberation of 14 ± 6 d after tracheostomy. Among patients off mechanical ventilation, 5 (63%) had their tracheostomies removed prior to discharge. The average intensive care length of stay was 47 ± 13 d (range 29-74 d) and the average hospital stay was 59 ± 16 d (range 34-103 d). CONCLUSIONS: This study reports promising outcomes in COVID-19 patients with acute respiratory failure and need for prolonged ventilation who undergo tracheostomy during their hospitalization. Further research is warranted to establish appropriate indications for tracheostomy in COVID-19 and confirm outcomes. Elsevier Inc. 2021-10 2021-04-27 /pmc/articles/PMC8075851/ /pubmed/34087619 http://dx.doi.org/10.1016/j.jss.2021.04.023 Text en © 2021 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Goldstein, Carma Deisher, David Gorman, Elizabeth Sheikh, Fariha Sifri, Ziad Glass, Nina E. Tracheostomy is Safe in Patients with Prolonged Intubation After Coronavirus Disease 2019 Infection |
title | Tracheostomy is Safe in Patients with Prolonged Intubation After Coronavirus Disease 2019 Infection |
title_full | Tracheostomy is Safe in Patients with Prolonged Intubation After Coronavirus Disease 2019 Infection |
title_fullStr | Tracheostomy is Safe in Patients with Prolonged Intubation After Coronavirus Disease 2019 Infection |
title_full_unstemmed | Tracheostomy is Safe in Patients with Prolonged Intubation After Coronavirus Disease 2019 Infection |
title_short | Tracheostomy is Safe in Patients with Prolonged Intubation After Coronavirus Disease 2019 Infection |
title_sort | tracheostomy is safe in patients with prolonged intubation after coronavirus disease 2019 infection |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075851/ https://www.ncbi.nlm.nih.gov/pubmed/34087619 http://dx.doi.org/10.1016/j.jss.2021.04.023 |
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