Corona-steps for tracheotomy in COVID-19 patients: A staff-safe method for airway management

D’Ascanio, Luca; Latini, Giulio; Pandolfini, Manlio; Giardini, Damiano

doi:10.1016/j.oraloncology.2020.104731

Cited by 7 publications

(10 citation statements)

References 4 publications

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“…Head and neck surgical procedures often require a relevant amount of healthcare resources in addition to potential infectious risks for healthcare workers, which may affect the decision to postpone or modify the surgery in case of financial restrictions or different use of economic/personnel resources (i.e. for Intensive Care Units or Covid Departments) [6] , [7] , [8] , [9] . For example, free flap reconstructive surgery requires longer operative times and postoperative intensive care unit (ICU) occupancy [9] .…”

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confidence: 99%

Covid-19 negatively impacted on small oncology surgery but none on major procedures: Regional experience

et al. 2022

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Aim to understand the impact of COVID pandemic on the activity and patients’ care of the Head and Neck regional Unit, temporary moved in a COVID-free hospital. Methods we retrospectively analyzed the yearly activity of the “Head & Neck Cancer Unit” at the Azienda Ospedali Riuniti Marche Nord (Italy) during 2020 (COVID-19 pandemic) and we compared it with the one performed in 2019. Statistical analyses were performed using Chi-square. Results No significant differences were observed comparing the total number of patients treated for H&N squamous cell carcinoma (SCC) in 2019 with the ones in 2020. Moreover, no differences were identified in term of cancer stage at the moment of the surgery between 2019 and 2020. On the contrary, a significant reduction in the number of surgical procedures carried out for thyroid (p<0.05) and skin (p<0.001) malignancies was identified. Conclusions Despite Covid-19 limitations, our institution was able to preserve the number of major oncologic procedures without negative impact on patients’ care. We believe that the creation of specific COVID-free hospital can be the key preserve quality of care in epidemic emergency.

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confidence: 99%

Covid-19 negatively impacted on small oncology surgery but none on major procedures: Regional experience

et al. 2022

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“…En principio, el número de personas en el quirófano debe ser el menor posible [29][30][31] . Minimizar el tiempo de exposición es clave para evitar el contagio durante el procedimiento 32 .…”

Section: Equipo Médico Y Preparación Del Quirófanounclassified

Traqueotomías en pacientes críticos durante la pandemia por COVID-19. Estudio preliminar de nuestra experiencia en el Hospital La Paz de Madrid

Vera¹,

Carretero²,

Cevallos³

et al. 2020

j.maxilo

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El brote epidémico causado por el virus SARS-CoV-2 se encuentra plenamente activo en España. Alrededor del 10-15 % de los pacientes ingresados precisan cuidados en unidades de críticos, siendo intubados de forma prolongada y precisando la realización de traqueotomías. Se realiza un estudio observacional de las traqueotomías realizadas por nuestro Servicio de Cirugía Oral y Maxilofacial a pacientes COVID-19 de unidades de cuidados intensivos realizadas entre el 17 de marzo y el 17 de abril de 2020. El estudio analiza aspectos epidemiológicos y clínicos de los pacientes, el tipo de técnica quirúrgica empleada, el tiempo quirúrgico, el tipo de cánula empleada, las complicaciones postquirúrgicas y el seguimiento clínico de los pacientes. Un total de 22 pacientes fueron sometidos a traquetomía reglada abierta. Fueron dieciocho hombres y cuatro mujeres de edades entre 40 y 77 años (64,9 años de media). En todos los casos la realización de traqueotomía fue como consecuencia del proceso pulmonar por la neumonia bilateral COVID-19. Dos pacientes presentaron un neumotórax en el postoperatorio inmediato como complicación, un paciente falleció durante la realización del procedimiento y otro tras su llegada a la Unidad de Cuidados Intensivos tras la realización de la traqueotomía. A pesar de que la traqueotomía es una técnica quirúrgica reglada, las características especiales de los pacientes COVID-19 hacen de este procedimiento una situación crítica por la inestabilidad pulmonar y la rápida desaturación del paciente. Todo ello obliga a la realización del procedimiento por facultativos con experiencia para disminuir el tiempo quirúrgico y poder enfrentarse a cualquier eventualidad.

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“…2,3 Although several modifications to open and percutaneous tracheostomy have been described, 2,4 evidence is limited regarding the relative safety of techniques and some controversies are unresolved. 5,6 In this clinical case, we describe a patient who demonstrated external tracheal compression with superimposed acute COVID-19 infection. The surgical approach involved open tracheotomy with Bjork flap under local anesthesia, as previously performed in 23 of our COVID-19 patients with tracheostomy (not published data).…”

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confidence: 99%

“…5. The tracheostomy tube cannula (previously connected to Halyard system) 6 was swiftly placed into the tracheal lumen and insufflated at the appropriate pressure level. 6.…”

mentioning

confidence: 99%

“…Suction procedures were avoided. The tracheostomy tube cannula (previously connected to Halyard system) 6 was swiftly placed into the tracheal lumen and insufflated at the appropriate pressure level. The correct position of the cannula was verified with capnography, and once oximetry values demonstrated saturation >97%, the endotracheal tube was removed, and the patient was safely transferred to the COVID-19 cohort unit.…”

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Björk Flap Tracheotomy for COVID-19 Pneumonia With Massive Thyroid Struma: A Stable Airway to Expedite Ventilator Weaning

Stadio

Gradoni²,

Cingolani³

et al. 2020

Ear Nose Throat J

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Corona-steps for tracheotomy in COVID-19 patients: A staff-safe method for airway management

Cited by 7 publications

References 4 publications

Covid-19 negatively impacted on small oncology surgery but none on major procedures: Regional experience

Covid-19 negatively impacted on small oncology surgery but none on major procedures: Regional experience

Traqueotomías en pacientes críticos durante la pandemia por COVID-19. Estudio preliminar de nuestra experiencia en el Hospital La Paz de Madrid

Björk Flap Tracheotomy for COVID-19 Pneumonia With Massive Thyroid Struma: A Stable Airway to Expedite Ventilator Weaning

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