Early experience in tracheostomy and tracheostomy tube management in Covid-19 patients

Piccin, Ottavio; Albertini, Riccardo; Caliceti, Umberto; Cavicchi, Ottavio; Cioccoloni, Eleonora; Demattè, Marco; Ferri, Gian Gaetano; Macrı̀, Giovanni; Marrè, Pietro; Pelligra, Irene; Saggese, Domenico; Schiavon, Patrizia; Sciarretta, Vittorio; Sorrenti, Giovanni

doi:10.1016/j.amjoto.2020.102535

Cited by 22 publications

(47 citation statements)

References 7 publications

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“…Study characteristics are summarized in Table 1. 3,[19][20][21][22] When searching the websites of professional organizations, we found that 3 had produced relevant guidance documents. [13][14][15] Following data extraction and synthesis, the results were categorized according to practice domains for tracheostomy and laryngectomy.…”

Section: Results and Observationsmentioning

confidence: 99%

“…The main recommendations according to each practice area are shown in Table 2. 3,13,14,[19][20][21][22][23][24][25]…”

Section: Results and Observationsmentioning

confidence: 99%

“…Given this risk, the evidence supported modifications for the evaluation and management of this population's surgically modified airway, including delaying certain practices until viral testing is negative. [19][20][21] These modifications need to be considered according to local regulations regarding practice as well as the use of PPE.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…A systematic multidisciplinary approach to decannulation is typically undertaken to wean patients from tracheostomy, which often includes increasing periods of cuff deflation, use of speaking valves and caps, and/or tracheostomy cannula downsizing. 20,21 Because of the variable access to resources as well as operational mandates, approaches to decannulation in the current environment have been largely determined at the institution level, with recommendations including delaying the decannulation process until after 2 consecutive days of negative test results. 21…”

Section: Decannulationmentioning

confidence: 99%

“…20,21 Because of the variable access to resources as well as operational mandates, approaches to decannulation in the current environment have been largely determined at the institution level, with recommendations including delaying the decannulation process until after 2 consecutive days of negative test results. 21…”

Section: Decannulationmentioning

confidence: 99%

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Swallowing and Communication Management of Tracheostomy and Laryngectomy in the Context of COVID-19

Vergara

Starmer

Wallace

et al. 2021

JAMA Otolaryngol Head Neck Surg

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e are in the midst of a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). Management of patients with surgically modified airways, such as tracheostomy and laryngectomy, is challenging for the health care team in this novel context. Although there are few studies detailing infection rates and level of risk in the management, 1 those with tracheostomy and laryngectomy represent a potential transmission and infection risk for health care professionals 2,3 owing to the high viral load present in the upper aerodigestive tract. 4-6 Several professional organizations worldwide have published guidelines on the management of these patients for otorhinolaryngologists and head and neck surgeons. 7 Urgent and essential care provision is still required for these patients during the current pandemic, 8 and many more patients are requiring tracheostomy insertion as part of their recovery from severe COVID-19. 9 Multidisciplinary teams involved in the treatment of patients with tracheostomy or laryngectomy often include allied health professionals, such as speech-language pathologists (SLPs), who are responsible for the therapeutic restoration of swallowing and communication. 10,11 Speech-language pathologists are routinely involved with stoma and voice prosthe-sis care procedures and may perform suctioning of the lower airways. The objective of this study is to review and synthesize the literature regarding tracheostomy and laryngectomy management in the context of the COVID-19 pandemic to inform best practice and provide guidance for SLPs and the multidisciplinary team managing care for this population. Methods Using elements from a rapid review approach, 12 a comprehensive search of a single database and guidance documents published by relevant professional societies/organizations was completed. Guidelines unrelated to those of the current pandemic were also considered for synthesis. Two searches were conducted simultaneously using the PubMed database on May 15, 2020, using descriptors relevant to our objective-specifically, (1) tracheostomy, COVID-19, and SARS-CoV-2 using the Boolean operator and; and (2) laryngectomy, COVID-19, and SARS-CoV-2, also using the Boolean operator and. Using the selection criteria, a single reviewer (J.V.) screened all titles and abstracts for possible inclusion. Those meeting the criteria were selected for a full-text IMPORTANCE The care of patients with a surgically modified airway, such as tracheostomy or laryngectomy, represents a challenge for speech-language pathologists (SLPs) in the context of the coronavirus disease 2019 (COVID-19) pandemic. The objective was to review available publications and practice guidelines on management of tracheostomy and laryngectomy in the context of COVID-19. This study performed a review and synthesis of information available in the PubMed database and from national SLP organizations across 6 countries. OBSERVATIONS From the search, 22 publications on tracheostomy and...

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Section: Results and Observationsmentioning

confidence: 99%

“…The main recommendations according to each practice area are shown in Table 2. 3,13,14,[19][20][21][22][23][24][25]…”

Section: Results and Observationsmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Section: Decannulationmentioning

confidence: 99%

Section: Decannulationmentioning

confidence: 99%

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Swallowing and Communication Management of Tracheostomy and Laryngectomy in the Context of COVID-19

Vergara

Starmer

Wallace

et al. 2021

JAMA Otolaryngol Head Neck Surg

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

Staibano

Levin

McHugh

et al. 2021

JAMA Otolaryngol Head Neck Surg

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Personal protective equipment for ENT activity during COVID-19 pandemic

Farneti¹,

Sorace²,

Tasca³

2020

Eur Arch Otorhinolaryngol

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Background In the COVID-19 era physicians have to face with need to perform office procedures maintaining the maximum safety for both the patient and the Doctor himself. The purpose of this paper was to suggest some equipment useful to perform outpatient visits in an ENT setting. Methods A simple modification of the standard headlight used during an ENT visit provides the operator a better face protection without any impairment in vision and comfort. In addition, in order to perform a safer ENT examination, a droplet protective barrier has been adapted to the patient's chair. Results Both the devices have been texted with success during a period of 2 months in our ENT clinic. No cases of contamination have been registered among physicians. Conclusion A simple modification to a device used in the routine ENT activity implemented its protective efficacy with low costs. On the other hand, a more structured tool permitted to obtain a more protected environment during patient examination.

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Early experience in tracheostomy and tracheostomy tube management in Covid-19 patients

Cited by 22 publications

References 7 publications

Swallowing and Communication Management of Tracheostomy and Laryngectomy in the Context of COVID-19

Swallowing and Communication Management of Tracheostomy and Laryngectomy in the Context of COVID-19

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

Personal protective equipment for ENT activity during COVID-19 pandemic

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