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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...

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Autores principales: Goldstein, Carma, Deisher, David, Gorman, Elizabeth, Sheikh, Fariha, Sifri, Ziad, Glass, Nina E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2021
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.
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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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