Tracheostomy in the COVID19 Patients: Our Experience in 12 Cases

Abstract

The incidence of tracheostomy has been significantly increased with the increase of patients admitted to the intensive care units. Looking into the literature, there have been various protocols proposed in the past for tracheostomy in COVID 19 patients. In the present case series, we have presented our experience of surgical tracheostomy in COVID 19 patients. It is a retrospective case series consisting of 12 COVID 19 patients who underwent tracheostomy from April 2020 to October 2020. We have discussed the tracheostomy in COVID 19 patients with references to their respective indication, location, the procedure, postoperative care and clinical outcomes. Of 12 patients, 6 were operated in the COVID ICU and 6 were operated in the COVID OT. The average duration of the intubation was 4 days (range 3-7 days). The average period of weaning was found to be 65 h (range 48 h 80 h). Of 4 patients associated with comorbidities, two had died 48 h after the surgery. The Primary indication of the tracheostomy can be made flexible based on the infrastructure of the hospital to accommodate increased patient load in a developing country like India. The location and surgical approach does not significantly affect the clinical outcomes of tracheostomy, and it can be safely performed in ICU/OT with adequate ventilation. Irrespective of the COVID status of the patients, Personal Protective Equipment (PPE) can ensure adequate protection to the health care personals preventing the spread of infection.

Association of Tracheostomy With Outcomes in Patients With COVID-19 and SARS-CoV-2 Transmission Among Health Care Professionals

“…The database search generated 1877 citations, of which 156 (8.3%) underwent full-text review (Figure 1). Overall, 69 studies (N = 4669 patients) were included within the qualitative synthesis, and 14 studies were included in the meta-analyses . Interrater reliability between independent reviewers was 0.81 and 0.64 for the abstract screening and full-text stages, respectively.…”

Weaning Outcomes and 28-day Mortality after Tracheostomy in COVID-19 Patients in Central India: A Retrospective Observational Cohort Study

“…In Indian scenario, small case series have reported early tracheostomy within 4–12 days after intubation in COVID-19, most likely due to overcrowded ICU with high demand of ventilatory equipment in a pandemic. 6 , 28 …”

Comparação da mortalidade entre traqueostomia precoce e tardia em pacientes internados por COVID-19 em uma unidade de terapia intensiva

“…O procedimento diminui a necessidade de sedação, evita traumas induzidos por pressão (tanto na traquéia quanto na cavidade oral) e pode reduzir o descondicionamento físico grave associado à ventilação mecânica prolongada (Chao et al, 2020;Mahmood el tal., 2021). Além disso, melhora a higiene pulmonar, diminui o risco de lesão laríngea crônica e acelera a reabilitação (Pradhan et al, 2021).…”