Timing of Tracheotomy in Intubated Patients With COVID-19

Otolaryngol Head Neck Surg. 2020 Aug;163(2):328-329. doi: 10.1177/0194599820930668. Epub 2020 May 19.

Abstract

Timing of elective tracheotomy in the intensive care unit for intubated patients with COVID-19 is still unclear. Recent recommendations and guidelines describe the surgical steps to achieve maximum protection of the involved medical staff and propose a delay of the procedure, so the viral load is decreased. Most authors of these recommendations agree that tracheotomy should be performed after at least 14 days from intubation, but data on this subject are still lacking. We discuss the issue of timing for such a procedure in regard to viral load and propose that the decision should be predominately based on its calculation.

Keywords: COVID-19; coronavirus; intensive care unit; tracheotomy; viral load.

MeSH terms

  • Betacoronavirus / isolation & purification*
  • Coronavirus Infections / surgery*
  • Coronavirus Infections / therapy
  • Coronavirus Infections / virology*
  • Elective Surgical Procedures
  • Humans
  • Intensive Care Units
  • Intubation, Intratracheal
  • Pandemics
  • Pneumonia, Viral / surgery*
  • Pneumonia, Viral / therapy
  • Pneumonia, Viral / virology*
  • Respiration, Artificial
  • Time Factors
  • Tracheotomy*
  • Viral Load*

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2