Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic

Sommer, Doron D.; Engels, Paul T.; Weitzel, Erik K.; Khalili, Sammy; Corsten, Martin; Tewfik, Marc A.; Fung, K.; Côté, David; Gupta, Mrigank S.; Sne, Niv; Brown, Timothy; Paul, Jayanta; Kost, Karen; Witterick, Ian J.

doi:10.1186/s40463-020-00414-9

Cited by 127 publications

(163 citation statements)

References 13 publications

Supporting

Mentioning

136

Contrasting

Unclassified

Order By: Relevance

“…Although ultrasound and bronchoscopy guidance might improve safety, the likelihood of aerosol generation is increased with PDT compared with open approaches [30] . Some authors advised to avoid PDT in order to reduce the time of apnea and viral exposure for medical staff [31] . In accordance with our results concerning complication rates, we think that OST should be preferred for several reasons.…”

Section: Discussionmentioning

confidence: 99%

Comparison of percutaneous dilatational tracheotomy versus open surgical technique in severe COVID-19: Complication rates, relative risks and benefits

et al. 2021

View full text Add to dashboard Cite

Objective Patients with acute respiratory failure due to COVID-19 have a high likelihood of needing prolonged intubation and may subsequently require tracheotomy. Usually, the choice of technique (percutaneous dilatational tracheotomy [PDT] versus open surgical tracheotomy [OST]) depends on the preference of surgeons and patient-related factors. In case of COVID-19, airborne spread of viral particles and limited time of apnea must be considered in the choice of the safest technique. The aim of this study is to compare the complication rates and offer an assessment of relative risks and benefits of PDT versus OST in patients with severe COVID-19. Methods We performed a retrospective study considering 47 consecutive patients affected by severe acute respiratory distress syndrome due to SARS-CoV-2 infection, needing invasive mechanical ventilation and subsequent tracheostomy. This study was performed at the Intensive Care Unit of our tertiary referral center. Complication rates were analyzed. Results Seventeen patients underwent PDT and 30 patients were submitted to OST. Twenty-six patients (55.3%) had post-operative complications (local infection, hemorrhage, subcutaneous emphysema) with no significant difference between PDT and OST. Conclusion PDT and OST are characterized by similar postoperative complication rates in severe COVID-19 patients. These findings suggest that OST might be preferred if expert ENT surgeons are available, as PDT could result in longer apnea and exposure to generated aerosol. However, authors recommend considering either OST or PDT at the discretion of the medical staff involved, according to the personal experience of the operators performing the procedure.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of percutaneous dilatational tracheotomy versus open surgical technique in severe COVID-19: Complication rates, relative risks and benefits

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Several groups of ORLs subsequently provided recommendations based on limited evidence for otorhinolaryngological procedures [2] which were rapidly adopted worldwide. These published papers and web-based statements contain precise recommendations for the performance of certain surgical procedures (e.g., tracheostomies) [9][10][11][12][13][14][15][16][17]. Others provide general protection advice for ORLs [18][19][20][21][22][23][24][25][26][27] or similarly atrisk disciplines [28,29].…”

Section: Introductionmentioning

confidence: 99%

Results of a national web-based survey on the SARS-CoV-2 infectious state of otorhinolaryngologists in Germany

Herzog

Beule

Lüers

et al. 2020

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Purpose SARS-CoV-2 is detected on the mucosa of the upper airways to a high degree. In the course of the COVID-19 pandemic, otorhinolaryngologists (ORL) are assumed to be at high risk due to close contact with the mucosa of the upper airways. No data are yet available providing evidence that ORLs have an increased risk of infection. Methods German ORLs were invited via e-mail through the German Society of ORL, Head and Neck Surgery and the German ENT Association to participate in a web-based survey about infection with SARS-CoV-2 and development of COVID-19. Data of infections and concomitant parameters in German ORLs were collected and compared to the total number of infections in Germany. Results Out of 6383 German ORLs, 970 (15%) participated. 54 ORLs reported testing positive for SARS-CoV-2. Compared to the total population of Germany, ORLs have a relative risk of 3.67 (95% CI 2.82; 4.79) of contracting SARS-CoV-2. Domestic quarantine was conducted in 96.3% of cases. Two individuals were admitted to hospital without intensive care. No casualties were reported. In 31 cases, the source of infection was not identifiable whereas 23 had a clear medical aetiology: infected patients: n = 5, 9.26%; medical staff: n = 13, 14.1%. 9.26% (n = 5) of the identified cases were related to contact to infected family members (n = 3), closer neighbourhood (n = 1) or general public (n = 1). There was no identified increased risk of infection due to performing surgery. Conclusion German ORLs have an almost 3.7-fold risk of contracting SARS-CoV-2 compared to the population baseline level. Appropriate protection appears to be necessary for this occupational group.

show abstract

“…Tracheostomies must be a safer procedure during the pandemic. Delay in indications protect pacients from unnecessary procedures and expose the team to a lesser risk of contamination due to a decreased virus count on patient airway [5] [6].…”

Section: Resultsmentioning

confidence: 99%

Considerations about Timing to Perform Elective Tracheostomies in Patients Hospitalized in COVID-19 Units

Souza¹,

Ahumada²,

Carraro³

2020

View full text Add to dashboard Cite

Since the beginning of the pandemic caused by the new Coronavirus (SARS-CoV-2), critically ill patients care has been challenging. It is necessary to perform the best available practice and protect the health team, preserving human resources and rationalizing costs. Changes in tracheostomies institutional protocols are necessary according to each health care services reality. This is particular important in developing countries. The aim of this study is to establish a practical and sucint guideline to minimize controversies regarding the proper timing to perform elective tracheostomies in critically ill coronavirus infected patients.

show abstract

Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic

Cited by 127 publications

References 13 publications

Comparison of percutaneous dilatational tracheotomy versus open surgical technique in severe COVID-19: Complication rates, relative risks and benefits

Comparison of percutaneous dilatational tracheotomy versus open surgical technique in severe COVID-19: Complication rates, relative risks and benefits

Results of a national web-based survey on the SARS-CoV-2 infectious state of otorhinolaryngologists in Germany

Considerations about Timing to Perform Elective Tracheostomies in Patients Hospitalized in COVID-19 Units

Contact Info

Product

Resources

About