Aerosol-generating procedure; percutaneous versus surgical tracheostomy

Am J Otolaryngol. 2022 May-Jun;43(3):103401. doi: 10.1016/j.amjoto.2022.103401. Epub 2022 Feb 17.

Abstract

Purpose: This study aims to compare percutaneous tracheostomy (PCT) and surgical tracheostomy's aerosol and droplet scattering by using a particle counter.

Materials and methods: This study was carried out with 35 patients between October 2020 and June 2021. All personal protective equipment was provided to protect healthcare workers. Measurements were made in the 5 s period before the tracheal incision and the 5 s period after the tracheal incision.

Results: The mean age of the 15 female and 20 male patients in this study was 68.88 ± 13.48 years old (range: 33-95 years old). Patients were intubated for an average of 22 days. Particle amounts were found to be significantly higher at 5 μm (p = 0.003) and 10 μm (p = 0.012) during PCT. In surgical tracheostomy, there was no significant increase in the number of particles. When the particle measurement values of both methods were compared with each other, there was a significantly more particle scattering in PCT than in surgical tracheotomy at 0.3 μm (p = 0.034), 5 μm (p = 0.001), and 10 μm (p = 0.003).

Conclusion: According to the data in our study, a surgical tracheotomy was not identified as an aerosol-generating procedure. Considering the risk of airborne transmission may increase due to viral mutations, we have shown that surgical tracheostomy may be more appropriate in patients who need a tracheostomy. Of course, the use of personal protective equipment during these processes is very important.

Keywords: Aerosol-generating procedures; Percutaneous tracheostomy; Surgical tracheostomy.

MeSH terms

  • Adult
  • Aerosols
  • Aged
  • Aged, 80 and over
  • COVID-19*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Personal Protective Equipment
  • Tracheostomy* / methods
  • Tracheotomy

Substances

  • Aerosols