Open Tracheostomy for Critically Ill Patients with COVID-19

Estefanía Hernández-García; Mar Martínez-RuizCoello; Andrés Navarro Mediano; Nuria Pérez-Martín; Victoria García-Peces; Carlos Velayos; Belen Rodríguez-Campoo; Guillermo Plaza

doi:10.1155/2020/8861013

Open Tracheostomy for Critically Ill Patients with COVID-19

Int J Otolaryngol. 2020 Nov 30:2020:8861013. doi: 10.1155/2020/8861013. eCollection 2020.

Authors

Estefanía Hernández-García¹, Mar Martínez-RuizCoello¹, Andrés Navarro Mediano¹, Nuria Pérez-Martín¹, Victoria García-Peces¹, Carlos Velayos², Belen Rodríguez-Campoo³, Guillermo Plaza¹

Affiliations

¹ Department of Otorhinolaryngology, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, Spain.
² Department of Intensive Care, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, Spain.
³ Department of Anesthesiology, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, Spain.

Abstract

Background: COVID-19 is a worldwide pandemic, with many patients requiring prolonged mechanical ventilation. Tracheostomy can shorten ICU length of stay and help weaning. Aims/Objectives. To describe the long-term evolution of the critically patient with COVID-19 and the need for invasive mechanical ventilation and orotracheal intubation (OTI), with or without tracheostomy. Material and Methods. A prospective study was performed including all patients admitted to the ICU due to COVID-19 from 10^th March to 30^th April 2020. Epidemiological data, performing a tracheostomy or not, mean time of invasive mechanical ventilation until tracheotomy, mean time from tracheotomy to weaning, and final outcome after one month of minimum follow-up were recorded. The Otolaryngology team was tested for COVID-19 before and after the procedures.

Results: Out of a total of 1612 hospital admissions for COVID-19, only 5.8% (93 patients) required ICU admission and IOT. Twenty-seven patients (29%) underwent a tracheostomy. After three months, within the group of tracheotomized patients, 29.6% died and 48.15% were extubated in a mean time of 28.53 days. In the nontracheostomized patients, the mortality was 42.4%.

Conclusions: Tracheostomy is a safe procedure for COVID-19 and helps weaning of prolonged OTI. Mortality after tracheostomy was less common than in nontracheostomized patients.