Open Tracheostomy for Critically Ill Patients with COVID-19

Abstract EN

Background.

COVID-19 is a worldwide pandemic, with many patients requiring prolonged mechanical ventilation.

Tracheostomy can shorten ICU length of stay and help weaning.

Aims/Objectives.

To describe the long-term evolution of the critically patient with COVID-19 and the need for invasive mechanical ventilation and orotracheal intubation (OTI), with or without tracheostomy.

Material and Methods.

A prospective study was performed including all patients admitted to the ICU due to COVID-19 from 10th March to 30th April 2020.

Epidemiological data, performing a tracheostomy or not, mean time of invasive mechanical ventilation until tracheotomy, mean time from tracheotomy to weaning, and final outcome after one month of minimum follow-up were recorded.

The Otolaryngology team was tested for COVID-19 before and after the procedures.

Results.

Out of a total of 1612 hospital admissions for COVID-19, only 5.8% (93 patients) required ICU admission and IOT.

Twenty-seven patients (29%) underwent a tracheostomy.

After three months, within the group of tracheotomized patients, 29.6% died and 48.15% were extubated in a mean time of 28.53 days.

In the nontracheostomized patients, the mortality was 42.4%.

Conclusions.

Tracheostomy is a safe procedure for COVID-19 and helps weaning of prolonged OTI.

Mortality after tracheostomy was less common than in nontracheostomized patients.