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Bronchoscopy-guided percutaneous tracheostomy during the COVID-19 pandemic

BACKGROUND: Assessment of the efficacy and complications associated with performing bronchoscopy-guided percutaneous tracheostomy in COVID-19 and non–COVID-19 patients. METHODS: Prospective observational study conducted between March of 2020 and February of 2022. All adult patients who underwent ele...

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Autores principales: Carboni Bisso, Indalecio, Ruiz, Victoria, Huespe, Iván Alfredo, Rosciani, Foda, Cantos, Joaquín, Lockhart, Carolina, Fernández Ceballos, Ignacio, Las Heras, Marcos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9771743/
https://www.ncbi.nlm.nih.gov/pubmed/36621447
http://dx.doi.org/10.1016/j.surg.2022.12.010
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author Carboni Bisso, Indalecio
Ruiz, Victoria
Huespe, Iván Alfredo
Rosciani, Foda
Cantos, Joaquín
Lockhart, Carolina
Fernández Ceballos, Ignacio
Las Heras, Marcos
author_facet Carboni Bisso, Indalecio
Ruiz, Victoria
Huespe, Iván Alfredo
Rosciani, Foda
Cantos, Joaquín
Lockhart, Carolina
Fernández Ceballos, Ignacio
Las Heras, Marcos
author_sort Carboni Bisso, Indalecio
collection PubMed
description BACKGROUND: Assessment of the efficacy and complications associated with performing bronchoscopy-guided percutaneous tracheostomy in COVID-19 and non–COVID-19 patients. METHODS: Prospective observational study conducted between March of 2020 and February of 2022. All adult patients who underwent elective bronchoscopy-guided percutaneous tracheostomy were included. The efficacy of the procedure was evaluated based either on the success rate in the execution or on the need for conversion to open technique. Percutaneous tracheostomy-related complications were registered during the procedure. We performed 6-month follow-up for identifying late complications. RESULTS: During the study period, 312 bronchoscopy-guided percutaneous tracheostomies were analyzed. One hundred and eighty-three were performed in COVID-19 patients and 129 among non–COVID-19 patients. Overall, 64.1% (200) of patients were male, with a median age of 66 (interquartile range 54–74), and 65% (205) presented at least 1 comorbidity. Overall, oxygen desaturation was the main complication observed (20.8% [65]), being more frequent in the COVID-19 group occurring in 27.3% (50) with a statistically significant difference versus the non–COVID-19 patients’ group (11.6% [15]); P < .01). Major complications such as hypotension, arrhythmias, and pneumothorax were more frequently observed among COVID-19 patients as well but with no significant differences. Percutaneous tracheostomy could be executed quickly and satisfactorily in all the patients with no need for conversion to the open technique. Likewise, no suspension of the procedure was required in any case. During 6-month follow-up, we found an incidence of 0.96% (n = 3) late complications, 2 tracheal granulomas, and 1 ostomal infection. CONCLUSION: Bronchoscopy-guided percutaneous tracheostomy can be considered an effective and safe procedure in COVID-19 patients. Nevertheless, it is highly remarkable that in the series under study, a great number of COVID-19 patients presented oxygen desaturation during the procedure.
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spelling pubmed-97717432022-12-22 Bronchoscopy-guided percutaneous tracheostomy during the COVID-19 pandemic Carboni Bisso, Indalecio Ruiz, Victoria Huespe, Iván Alfredo Rosciani, Foda Cantos, Joaquín Lockhart, Carolina Fernández Ceballos, Ignacio Las Heras, Marcos Surgery Covid-19 BACKGROUND: Assessment of the efficacy and complications associated with performing bronchoscopy-guided percutaneous tracheostomy in COVID-19 and non–COVID-19 patients. METHODS: Prospective observational study conducted between March of 2020 and February of 2022. All adult patients who underwent elective bronchoscopy-guided percutaneous tracheostomy were included. The efficacy of the procedure was evaluated based either on the success rate in the execution or on the need for conversion to open technique. Percutaneous tracheostomy-related complications were registered during the procedure. We performed 6-month follow-up for identifying late complications. RESULTS: During the study period, 312 bronchoscopy-guided percutaneous tracheostomies were analyzed. One hundred and eighty-three were performed in COVID-19 patients and 129 among non–COVID-19 patients. Overall, 64.1% (200) of patients were male, with a median age of 66 (interquartile range 54–74), and 65% (205) presented at least 1 comorbidity. Overall, oxygen desaturation was the main complication observed (20.8% [65]), being more frequent in the COVID-19 group occurring in 27.3% (50) with a statistically significant difference versus the non–COVID-19 patients’ group (11.6% [15]); P < .01). Major complications such as hypotension, arrhythmias, and pneumothorax were more frequently observed among COVID-19 patients as well but with no significant differences. Percutaneous tracheostomy could be executed quickly and satisfactorily in all the patients with no need for conversion to the open technique. Likewise, no suspension of the procedure was required in any case. During 6-month follow-up, we found an incidence of 0.96% (n = 3) late complications, 2 tracheal granulomas, and 1 ostomal infection. CONCLUSION: Bronchoscopy-guided percutaneous tracheostomy can be considered an effective and safe procedure in COVID-19 patients. Nevertheless, it is highly remarkable that in the series under study, a great number of COVID-19 patients presented oxygen desaturation during the procedure. Elsevier Inc. 2023-04 2022-12-22 /pmc/articles/PMC9771743/ /pubmed/36621447 http://dx.doi.org/10.1016/j.surg.2022.12.010 Text en © 2022 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 Covid-19
Carboni Bisso, Indalecio
Ruiz, Victoria
Huespe, Iván Alfredo
Rosciani, Foda
Cantos, Joaquín
Lockhart, Carolina
Fernández Ceballos, Ignacio
Las Heras, Marcos
Bronchoscopy-guided percutaneous tracheostomy during the COVID-19 pandemic
title Bronchoscopy-guided percutaneous tracheostomy during the COVID-19 pandemic
title_full Bronchoscopy-guided percutaneous tracheostomy during the COVID-19 pandemic
title_fullStr Bronchoscopy-guided percutaneous tracheostomy during the COVID-19 pandemic
title_full_unstemmed Bronchoscopy-guided percutaneous tracheostomy during the COVID-19 pandemic
title_short Bronchoscopy-guided percutaneous tracheostomy during the COVID-19 pandemic
title_sort bronchoscopy-guided percutaneous tracheostomy during the covid-19 pandemic
topic Covid-19
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9771743/
https://www.ncbi.nlm.nih.gov/pubmed/36621447
http://dx.doi.org/10.1016/j.surg.2022.12.010
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