Healthcare Personnel Safety During Percutaneous Tracheostomy in Patients With COVID-19: Proof-of-Concept Study

Sood, Rahul; Dudiki, Natasha; Alape, Daniel; Maxfiel, Mark W

doi:10.1177/0885066620980384

Cited by 10 publications

(10 citation statements)

References 17 publications

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“…All procedures were done using PDT with our previously described technique. 11 The mean age was 59 standard deviation (SD = 16) years, 22 (59%) were male, and mean body mass index was 32 (SD = 7.4) ( Table 1 ). The mean APACHE II score at the time of ICU admission was 19 (SD = 8.7).…”

Section: Resultsmentioning

confidence: 99%

“…No staff was allowed inside the room for at least one-hour post procedure unless absolutely required. 11 …”

Section: Methodsmentioning

confidence: 99%

“…After being liberated from mechanical ventilation for 72 h, all patients were started in our decannulation protocol based on multidisciplinary input from services including respiratory therapy, nursing, pulmonology, thoracic surgery, and critical care medicine. 11 Patients were assessed on a daily basis by our respiratory therapy team. Every patient after being weaned off mechanical ventilation was also evaluated by a speech pathologist for swallowing assessment and speech.…”

Section: Methodsmentioning

confidence: 99%

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COVID-19 Tracheostomy: Experience in a University Hospital With Intermediate Follow-up

Sood

Palleiko

Alape-Moya

et al. 2021

J Intensive Care Med

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The benefits of percutaneous dilational tracheostomy (PDT) placement have been well documented in patients requiring prolonged mechanical ventilation. However, the data regarding the benefit of PDT in coronavirus-2019 (COVID-19) patients are scarce. The objective of this study is to evaluate the outcomes of a cohort of 37 patients who underwent tracheostomy as part of their COVID-19 care. Retrospective data from a series for 37 patients undergoing tracheostomy was collected using chart review. Primary outcomes included 30 and 60 day mortality, weaning rate, and decannulation rate. Secondary outcomes collected included admission demographics, comorbidities, and procedural information. Thirty-seven (37) patients requiring prolonged mechanical ventilation due to COVID-19. Of these 37 patients, 35 were alive 60 days post-PDT placement, 33 have been weaned from mechanical ventilation and 18 have been decannulated. The low mortality and high decannulation rates in this cohort in is a promising development in the care of critically ill COVID-19 patients. Of note, all participating physicians underwent routine polymerase chain reaction (PCR) testing for infection with the severe acute respiratory syndrome coronavirus-2 virus and no physician contracted COVID-19 as a result of their involvement. Overall, this case series describes the modified PDT technique used by our team and discusses the feasibility and potential benefit to PDT placement in COVID-19 patients requiring long-term mechanical ventilation.

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Section: Resultsmentioning

confidence: 99%

“…No staff was allowed inside the room for at least one-hour post procedure unless absolutely required. 11 …”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

COVID-19 Tracheostomy: Experience in a University Hospital With Intermediate Follow-up

Sood

Palleiko

Alape-Moya

et al. 2021

J Intensive Care Med

Self Cite

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“…Meyer et al reported bronchoscope guided PDT decreased the risk of bleeding in comparison to open tracheostomies, considering the high rate of anti-coagulation therapy required for these patients. Guided PDT reduced transmission of virus to HCWs from critically ill COVID-19 patients [15, 68-69], although there was no major difference in complication rate in PDT compared to open tracheostomy [64, 61]. However, in a pre-COVID study demonstrated that use of bronchoscopes did not affect the overall outcome in patients with open or percutaneous tracheostomy [70].…”

Section: Discussionmentioning

confidence: 99%

Therapeutic and Interventional Bronchoscopy Performed in Critically ill COVID-19 patients: A Systematic Review

Samadder

2022

Preprint

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Background: Coronavirus disease 2019 (COVID19) is a highly infectious disease responsible for huge number of deaths in global population. Bronchoscopy was contraindicated for acute respiratory failure in critical patients due to possible transmission of virus to healthcare provider due to aerosol generating procedure (AGP). The safety, efficacy, complication rate, deaths, and transmission rate of virus to healthcare workers due to therapeutic and interventional bronchoscopy performed on COVID19 patients are accessed. Methods: A systematic review of literature was performed as per PRISMA 2020 guidelines. To obtain literatures available in PubMed, MEDLINE, and Google Scholars with timeline from 1st Jan 2020 to 10th Dec 2021. Databases were searched with MeSH terms bronchoscopy and COVID-19 it fetched 7350 articles. Applying primary inclusion criteria of bronchoscopy in COVID19 patients. Secondary inclusion criteria therapeutic and interventional bronchoscopy excluding the articles on diagnostic bronchoscopy. Result: Total 72 clinically relevant literatures were identified and included for further review. 1887/2558 patients underwent bronchoscopy for treatment of severe or critical COVID19 pneumonia. therapeutic bronchoscopy was performed in 1241/1887 (65.8%) patients and interventional bronchoscopy was performed in 831/1887 (44.03%) patients. Overall, complications observed in 200/1887 (10.5%) patients. Total, 579/1887 (30%) patients died as per the literatures. Total 15 HCW (8%) were found infected during the studies. It led to successful completion of procedures in 924/940 (98.3%) patients. All three types of bronchoscopes were found to be safe for the patients. The safety, efficacy, complication rate to be 97.5%, and 98.3%, and 2.5% respectively in severely SARSCoV2 infected patients undergoing bronchoscopy. Conclusion: This study suggests that bronchoscopy is a safe and effective procedure to be performed in patients suffering from COVID19 pneumonia. Proper use of personal protective equipments (PPE) during bronchoscopic procedure reduced the risk of transmission of the virus from the patients to the healthcare provider.

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“…7 The question of which type of tracheostomy (percutaneous or open tracheostomy) is safer for staff remains controversial. 5,8…”

mentioning

confidence: 99%

In Reference to Voice, Swallow and Airway Outcomes Following Tracheostomy for COVID‐19

2021

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We read with huge interest the manuscript of Rouhani et al. entitled "A Prospective Study of Voice, Swallow, and Airway Outcomes following Tracheostomy for COVID-19". 1 The authors revealed the high incidence of laryngeal injury among patients who underwent intubation and tracheostomy insertion during the COVID-19 pandemic. It seems that this is a very interesting observation that can be an important argument in the discussion about the timing of tracheostomy in patients with COVID-19.Analyzing the literature from the beginning of 2020, we noticed that there is a trend to perform a later tracheotomy (after the 10th day of intubation). 2 Available evidence suggests that viral shedding is maximal in the first week of infection and the most of the article was devoted to safety methods during tracheotomy. 3,4 On the other hand, the results of the works from the second half of 2020 based on the expanded knowledge of SARS-CoV-2 and the results of several months of observation of patients after decannulation suggest an early tracheotomy (before the 10th day after intubation). 5 Kwak et al. to delay or avoid tracheostomy in COVID-19 patient categorically. 6 Reducing the duration of a tracheostomy is also important in preventing complications. Hernández Martínez et al. as a result of randomized controlled trial revealed that basing the decision to decannulate on suctioning frequency plus continuous high-flow oxygen therapy allow to reduce the time to decannulation. 7 The question of which type of tracheostomy (percutaneous or open tracheostomy) is safer for staff remains controversial. 5,8

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Healthcare Personnel Safety During Percutaneous Tracheostomy in Patients With COVID-19: Proof-of-Concept Study

Cited by 10 publications

References 17 publications

COVID-19 Tracheostomy: Experience in a University Hospital With Intermediate Follow-up

COVID-19 Tracheostomy: Experience in a University Hospital With Intermediate Follow-up

Therapeutic and Interventional Bronchoscopy Performed in Critically ill COVID-19 patients: A Systematic Review

In Reference to Voice, Swallow and Airway Outcomes Following Tracheostomy for COVID‐19

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